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RF_DIS_2_P_SUDHA
ESTIMATES OF HIV/AIDS
IN KARNATAKA STATE
Dr.V.Ravi,
Department of Neurovirology,
National Institute of Mental Health And Neuro
Sciences (NIMHANS),
Bangalore 560029,
Why are estimates of HIV
infection Important?
•To ascertain the burden of infection in
the community
•To devise strategies for HIV/AIDS
management
•To assess the impact of interventions at
later date.
What are the current estimates
of HIV infection in Karnataka?
• The current estimates for HIV infection in the
State range from 150,000 to 295,000 HIV
infected individuals within the state
• These estimates have been arrived at using
three different calculations;
(i)
Based on UNAIDS estimates
(ii) Based Sentinel Surveillance (ANC and
STD clinics) in Karnataka in 1999
Calculations based on UNAIDS
estimates
X
• UNAIDS estimates for India
= 3.5 million
(No. HIV Infections by end of 1999)
• Karnataka accounts for 5°/o of total population
within the country. 5% of 3.5 million = 175,
000
• Current estimates of HIV infection in Karnataka
is therefore 175, 000
Extrapolation from country's estimates can be
fallacious since the progression of the epidemic
varies from state to state
ii
How reliable are these estimates?
• Reliability depends on the number of
rounds of surveillance conducted in any
region
• The adherence to the Surveillance
protocol i.e.number of samples screened
(n=400 for ANC and n=250 for STD)
• All the data for the estimates come only
from the Government sector - what about
cases seen the private sector??
What then are the true estimates
of HIV infection in Karnataka?
The truth lies somewhere in between the
estimates arrived at by three means i.e.
1. Back calculation form UNAIDS country’s
estimates- i.e. 175,000
2. Calculations based on ANC surveillance data
in the State-i.e.153,750
3. Calculations based on STD surveillance data
within the state; i.e. 295,550
•6
Calculations based on Sentinnel
Surveillance
STD Clinic Surveillance
• Surveillance data of 1999 - Hubli 23.8%, Bellary 14.06%,
Mysore8.4% and Bangalore 16.79%
• Average for the State in the year 1999 = 15.76%
• Karnataks’s total Adult population = 15 millions
• Karnataka’s STD population = 1.86 millions(12.4% of 15X106)
• Karnataka’s HIV infected pouplation = 15.76% of 1.86 X 106
• Karnataka probably has 295,550 HIV infected individuals
Can be fallacious because surveillance includes only
those attending STD clinics - HRB population.
9
Calculations based on Sehtinnel
Surveillance
Antenatal Clinic SurveiEHasice
• Surveillance data of 1999 - Hubli 2%, Beilary 1,67%,
Kollegal 0.25% and Bangalore 0.25%.
• Average for the State in the year 1999 = 1.025%
• Karnataks’s total population
= 50 millions
• Karnataka’s sexually active adult population =15 millions
• Karnataka’s HIV infected pouplation = 1.02% of 15 X 106
• Karnataka probably has 153,750 HIV infected individuals
Can be fallacious because surveillance includes
only women who attend ANCs and not all adults.
Sentnnel Surveillance for HDV infection
at STD clinics in karnatka
Sentinnel Sites
)0
How is the epidemic progressing in
Karnataka?
The overall seropositivity rate of HIV
infection over the past seven years
2. Progression of HIV infection in the
1.
various age groups over the past 7 years
3. Progression of the epidemic in the various
districts over the past 7 years
This analysis is based on serosurveillance
reports obtained from VTCs within the state
Rate
Seropsitivity in distritcs over a 7 years period
HIGH PREVALENCE DISTRICTS FOR HIV
BIDAW
GULBAWQA
BUAPUR
Prevention and Care Djmamic of Systems for Del^ering HIV/AIDS
Care and Support
>
■
...............................
■
Intervention
Ben fi
Immediate Beneficiary
Primary Benefit
Build and improve
Linkages and referra
Systems among IIIV/
AIDS service
Pople living with
HIV/AIDS
Comprehensive cart
is provided
Organisations and
Other services,
Including TB control
And primary health
care
4
Mitigating Effect
Prevention
Improves health of
PLWIIAs by
ensuring access to a
wider range of care
Family and
community
receive IIIV
prevention
services for HIV/AED 5
related illnesses
education.
"s
I
H
Karnataka Burden of Disease Crude; Estimates
AIDS Deaths
AIDS Cases
Diagnosed HIV Cases;
Undiagnosed
HIV Cases
i—
:[83
1,648
Reported figures:
1987-Dec 2002
15,32.1
5,00,000*
* Assuming median pi e valence of 1.63% of adult population
india-canada
collaborative HIV/AIDS project
ichap
approach followed by ichap
•
Intersectoral collaboration
Evidence-based planning
Gender equity
Community participation
Involvement of PLWHAs
Sustainability
August 2002
NELSON MANDELA,
WORLD ECONOMIC FORUM, DAVOS, 1997
about ichap
India today has an estimated four million people living with
HIV/AIDS. In view of the rapid escalation of the epidemic, it is
predicted that the country will soon have the largest population
of people with HIV in the world. Given an already overburdened
health system, and the cumulative effects of poverty, ignorance
and inequities of class and gender, the HIV/AIDS epidemic
threatens to erode every gain in the fields of education, health
and development.
Recognizing the enormity of the threat posed by HIV/AIDS, the
Canadian International Development Agency (ClDA) has made
a commitment to provide assistance to the Government of India
for HIV/AIDS prevention and control.
Established in early 2001, rhe India-Canada Collaborative
HIV/AIDS Project (1CHAP) is a five-year project funded by
C1DA. ICHAP provides technical assistance to national and
state-level governmental and non-govemmental organizations in
the project states of Karnataka and Rajasthan.
ICHAP is implemented by a Canadian Executing Agency, a
consortium comprising the University of Manitoba, Mascen
Consultants and Proaction - Partners for Community Health.
The project works with and through its local partners - the
7
Karnataka State AIDS Prevention Society (KSAPS) and rhe
Rajasthan State AIDS Control Society (RSACS). Other key
stakeholders include NGOs, research institutions, the public
health system, media and the corporate sector.
mission
The project aims to mitigate the impact of rhe H1V/A1DS
epidemic on vulnerable individuals and groups by strengthening
the institutional capacity of key stakeholders in rhe planning,
designing, implementation and evaluation of programme
initiatives.
Sensiti^in," and mobilizing communities to address HIV/AIDS:
goals
• Strengthen the institutional capacity of the National AIDS
Control Organization (NACO), state AIDS societies and a
range of other organizations for prevention, care and support
relating to H1V/A1DS.
• Develop and pilot innovative programme models through
Demonstration Projects whose success can be replicated and
upscaled for larger impact.
a comprehensive, integrated approach
The 1CHAP model rests on a strong foundation of data gathering
and capacity building that support the planning and
implementation of programme ‘pillars’.
The key principles underpinning ICHAP's programmes are:
• Intersectoral collaboration
• Evidence-based planning
• Gender equity
• Community participation
• Involvement of people living with HIV/AIDS (PLWHAs)
• Sustainability
4
project states
ICHAP's programmes are based in two states: Karnataka and
Rajasthan. There is a strong rationale for capacity building and
expanding HIV programming in both states. The prevalence of
HIV is high in Karnataka (as is the case with some other
southern states), with rhe epidemic having reached all comers of
the state. While Rajasthan has a relatively lower HIV
prevalence, its poor social, health and development indicators,
significant migratory population and deeply entrenched
traditional rural sex work, render it extremely vulnerable to the
epidemic. Programme interventions in the state at this point
would play a critical role in controlling the progression and
impact of the epidemic.
capacity building
1CHAP helps to build the institutional capacity of both KSAPS
and RSACS and their partners in planning, implementation and
monitoring programme interventions. An assessment of training
needs is currently underway in both states.
communication and media advocacy
Communication is an integral part of efforts for the prevention
and control of HIV/A1DS and supports other programme areas
such as management of sexually transmitted infections (STIs),
voluntary counselling and testing (VCT), focussed interventions
and strategics such as condom promotion.
1CHAP works with KSAPS and RSACS to develop a
multi-pronged, synergistic communication strategy. The strategy
involves three approaches: increasing knowledge, changing
attitudes and supporting individuals and communities to adopt
HIV-preventive behaviours (behaviour change communication);
and creating an enabling environment that includes access to
quality services, supportive policies and positive social norms,
through media advocacy and social mobilization of a wide range of
partners.
Listening to voices at the grassnKHs: Women discuss problems relating to
migration in their communities. Jhunjhunu district, Rajasthan
Strategic interventions for communication include mass media
campaigns and capacity-building workshops for journalists and
radio/television producers in H1V/A1DS reporting and
production of “infotainment” programmes respectively. ICHAP
will also use information technology (IT) and develop
innovative, participatory' and indigenous approaches ro
communication, especially for rural, non-literate populations.
focussed prevention
Addressing the specific needs of populations that are especially
vulnerable to H1V/AIDS such as sex workers and migrants, as well
as those of people living with H1V/A1DS (PLWHAs), is critical.
NGOs serve as crucial links for working within such communities.
Strengthening existing partnerships with NGOs, increasing the
number of NGOs and their coverage of vulnerable populations,
and expanding geographic reach are important considerations.
ICHAP works with KSAPS and RSACS to develop a proactive
system of NGO selection, support and management. This includes
8
prioritizing interventions, assessing NGO capacity and establishing
partnerships, capacity building, monitoring and evaluation.
voluntary counselling and testing
Voluntary Counselling and Testing Centres (VCTCs) provide a
safe and confidential environment where people can receive non-
judgmental counselling on HIV vulnerability and prevention
issues, consider undergoing HIV testing on an informed consent
basis, and receive post-test counselling, referrals and support.
These centres, therefore, also serve as a critical entry point for
addressing issues relating to H1V/A1DS care and support.
It is proposed to increase the number of VCTCs in both
Karnataka and Rajasthan to ensure that every district has a
functioning VCTC. 1CHAP will provide ongoing comprehensive
training to VCTC staff in all district hospitals to encourage
quality counselling and support. In addition, VCTCs will
strengthen community resources and initiatives for rehabilitation.
legal aid, institutional and home-based care.
9
management of sexually transmitted
infections (STIs)
As in all other countries, sexual contact constitutes the main
route of HIV transmission in India, accounting for 83 percent of
all HIV infections. The presence of an STI not only increases
the biological risk of acquiring or transmitting the virus, but is
also an indication of the person's social and personal
vulnerability to HIV. Management of STIs is therefore a critical
intervention for the prevention and control of HIV/AIDS.
It is planned that by 2003 every district in Karnataka and
Rajasthan will be equipped with at least one health centre
specializing in STI services. ICHAP will strengthen facilities and
infrastructures at the district, block and taluka levels and train
health providers to offer quality, non-judgmental, client-friendly
services.
e
Addressing women's vulnerability to HIV/AIDS is a fundamental concern for the project
piloting innovations:
the demonstration projects
Piloting innovative demonstration models is a unique feature of
ICHAP. The experiences and lessons learned will be used to
upscale and replicate these models. ICHAP has taken a strategic
decision to locate these projects in rural and urban areas that are
characterized by a rapid progression of the HIV epidemic and a
relative lack of programming interventions. Focussed research
studies are underway to determine and understand specific local
needs relating to HIV/A1DS.
KARNATAKA
• District demonstration projects, including one in Bagalkot
featuring an intensive community-based rural H1V/AIDS
prevention model, and one in the more urbanized district of
Dharwad with an integrated district-level centralized model.
• A state-wide rural female sex work intervention project.
• An integrated state H1V/A1DS prevention and care project for
urban populations.
11
RAJASTHAN
• A community-based participatory model tor two
clusters of districts characterized by high rates of
migration among rural men and their families.
• A community-based participatory approach for
addressing traditional rural sex work among women
in two district clusters.
• A model tor care and support based on a
prevention-care continuum.
Building the capacity of communi tics to assess and map resources for HIV/Al DS
prevention and care: a training session in Dharwad district. Karnataka
“We must give hope to
those infected with HIV,
enabling them to plan
for life instead of
breparing for death. ”
UNITED NATIONS SECRETARY GENERAL KOFI ANNAN
WORLD HEALTH ASSEMBLY, GENEVA, 2001
ICHAP
Pisces Building
4/13-1 Crescent Road
High Grounds. Bangalore 560 001
Karnataka
Tel: 080 220 1237-9
Fax: 080 220 1373
E-mail: ichapblr@ichapindia.org
5Jamana I.al Bajaj Marg
Jaipur 302 005
Rajasthan
Tel: 0141 366 552/360 572
Fax: 0141 366 553
Email: ichapjpr@ichapindia.org
1CHAP Field Office
Population Research Centre
JSS Institute of Economic Research
Vidyagiri, Dharwad 580 004
Karnataka
Tel: 0836-461 170
Email: iciiap_dwd@sify.com
Web: www.ichapindia.org
An evolving response to the HTV-AIDS epidemic
in
Karnataka State, India
This relatively new health and social problem was recognised in India in 1986 and in
Karnataka in 1988
The first AIDS Surveillance Centre was set up in Bangalore
Medical College in 1987 with technical guidance from the Indian Council of Medical
Research. During 1989-94 the Blood Safety Programme, assisted by Government of
India, initiated the modernization of the blood banking system in Karnataka. The
State .AIDS Cell was established in 1992. From 1992-1998, Phase I of the National
AIDS Control Programme (NACP) was implemented with World Bank assistance
through. NACO (National Aids Control Organisation), Government of India
L'nder
this programme 10 zonal blood testing centres were established and 51 blood banks
(37 government. 15 private) were modernized. Sectoral Surveillance was carried out
through 7 STD clinics and one antenatal clinic.
Centres (VTCs) were set up.
Three Voluntary Blood Testing
Training of doctors and paramedical workers was
conducted. Health education and 1EC programmes reached out to communities using
a variety of media. STD clinics have been strengthened The Karnataka State .AIDS
Prevention Society (KSAPS) was registered . Phase II of the AIDS Control Project
was launched in December 1999 for a 5 year period till 2004, with World Bank
Assistance It aims to reduce the spread or transmission of HIV infection in the State
and to strengthen capacity to respond to HIV/AIDS on a long-term basis.
NGOs have been active, particularly in Bangalore. Three NGO's provide care and
support to People Living With AIDS (PLWA's) in Bangalore (one also has a home
based care programme), one for women in Chickmangalur while another is being
established in February, 2001 in Mangalore. A well women clinic is run by an NGO
in Bangalore; two other NGOs work with CSWs in Bangalore and Belgaum. Other
NGOs work with preventive education in schools and industries in and around
Bangalore; and with truckers in Raichur, Bangalore and Mangalore. Two networks
namely the .AIDS Forum Karnataka (AFK) and the Karnataka Network for People
Living with HIV/AIDS (KNP+) have been formed. Another NGO network, CHAIKA
has undertaken sensitization and training programmes for its member institutions
(over 300) working in different districts. A few mission and private hospitals provide
testing and inpatient facilities for HIV positive patients who need medical care.
Trainins of counsellors for HIV-AIDS is also carried out.
Other NGO's include
/;ycJnnuary ■ J '..'‘19:0: P\!
HIV/AIDS work as part of their overall health work.
For instance HIV/AIDS
awareness is part of womens health empowerment training programme. The National
Law School University of India takes an active part in legal and ethical aspects of
HIV/AIDS.
Thus over the years a slow but sure response to the HIV epidemic has evolved in
Karnataka.
Efforts are however inadequate and slow in respect of the rapidly
increasing trends in infection rates, "the spread of the infection into the general
community and evidence regarding growing vertical mother to child transmission.
There is need for
a. diagnostic facilities in each of the 27 districts to run as Voluntary Testing Centres
with counsellors and social workers.
b
provision of facilities for care of AIDS patients who may not be able to live with
their families.
c. treatment for opportunistic infections, particularly TB. This should be integrated
with general health care services,
d. provision of antiretroviral therapy at low cost. The state / country could use
provisions under WTO for indigenous production which would lower costs
Prevention Therapy to protect against mother to child transmission needs to be
more widely available.
e. management and Prevention of sexually transmitted diseases
f
training of networking for home based care, including use of herbal medicine and
other systems of healing with back-up support from referral hospitals.
g. promotion of healthy lifestyles among positive persons
h. preventive education among different groups, children, adolescents, womens
groups.
:r.7 . :.r
r'z/? e To The T'i'.T.''..
Karnataka State AIDS Prevention Society, Bangalore
March 2002
United Nations General Assembly
Twenty-sixth Special Session
Declaration of Commitment on HIV/AIDS
Wednesday 27th June 2001, New York
By 2003, ensure the development and implementation of multisectoral
national strategies and financing plans for combating HIV/AIDS that:
address the epidemic in forthright terms: confront stigma, silence
and denial.
address gender and age-based dimensions of the epidemic.
eliminate discrimination and marginalization.
involve partnerships with civil society and the business sector and
the full participation of people living with HIV/AIDS, those in
vulnerable groups and people mostly at risk, particularly women
and young people.
are resourced to the extent possible from national budgets without
excluding other sources, inter alia international cooperation.
fully promote and protect all human rights and fundamental
freedom, including the right to the highest attainable standard of
physical and mental health.
integrate a gender perspective: and address risk, vulnerability,
prevention, care, treatment and support and reduction of the
impact of the epidemic and
strengthen health, education and legal system capacity.
By 2003 integrate HIV/AIDS prevention, care, treatment and support
and impact mitigation priorities into the mainstream of development
planning, including in poverty eradication strategies, national budget
allocations and sectoral development plans.
Acknowledgement : KSAPS thanks Dr. V. Ravi and Dr. Jayashree Ramakrishna, Additional Professors at
NIMHANS, Bangalore, for their valuable inputs. It also thanks Avanti Communications, for the professional
layout, design and printing of the booklet, both in English & Kannada.
FOREWORD
With over 1% of its adult population estimated to be HIV positive, Karnataka is
now bracketed with the other high prevalence states of Maharashtra, Andhra
Pradesh, Tamil Nadu, Manipur and Nagaland. According to Government of
India estimates, Karnataka has an estimated 300,000 of the four million people
living with HIV/AIDS in the country.
The Karnataka State AIDS Prevention Society (KSAPS) has been in the forefront
in facing this unprecedented epidemic that threatens to slow down economic
growth and reduce life expectancy. The Government of Karnataka led by its
dynamic Chief Minister, Shri S.M. Krishna, has been quick to respond to the
challenge. Realising the gravity of the situation, the Chief Minister has been
personally monitoring the HIV/AIDS prevention strategies. Due to his initiative,
the Canada-Indian HIV/AIDS collaborative project has taken off and Voluntary
Counselling and Testing Centres are being established in all the districts of the
state. He has also recently taken the responsibility of becoming the Chairman
of the Project Governing Board of KSAPS, the first State AIDS Control Society in
the country with the Chief Minister himself directing its activities.
The Minister of Health and Family Welfare, Dr. Maalaka Raddy, has been a
constant source of encouragement to KSAPS and he has personally led rallies
and jathas to spread HIV/AIDS awareness. The Minister of State for Medical
Education, Smt. Nafees Fazal has inspired all the Medical colleges in the state
to redouble their efforts, especially in the areas of testing, training, surveillance
and research. KSAPS has taken a number of major steps to rapidly upscale its
efforts - an effort that is being guided by Shri A.K.M. Nayak, Principal Secretary
Health and Family Welfare, Government of Karnataka who also serves as
Chairman of the KSAPS Executive Committee.
This booklet traces Karnataka's steady and measured response to the HIV/AIDS
epidemic. It also profiles KSAPS' main activities and its future plans. KSAPS is
working closely with NGOs, the private sector, other government departments
and the media. We hope this publication will serve to inform as well as enthuse
all concerned citizens in the state in our common battle against this epidemic.
G. V.
Krishna Rau
Commissioner
Health & Family Welfare Services and
Project Director, KSAPS
Sri. S. M. Krishna
Chief Minister of Karnataka
MESSAGE
The first case of AIDS was detected in Karnataka as far back as 1988. The
crippling effect of ignorance, prejudice and discrimination has made the
fight against this seemingly uncontrollable epidemic even more complex.
The fatal nature of AIDS, the stigma attached to it, its association with
condemned behaviour, has produced a devastating and cruel scenario.
HIV/AIDS was until recently assumed to be confined to urban centres and
certain high-risk groups. The situation has changed rapidly, necessitating
a more radical and broad-based approach with a holistic set of
multi-sectoral interventions.
Combating the HIV/AIDS epidemic has become the Government's foremost
priority and we are addressing this as a major development issue. The
Government has already taken up several measures to control the epidemic
and I appeal to all sections of Society - Government, NGO groups, private
sector and all concerned citizens to support the Government's efforts.
S. M. Krishna
2
Dr. A. B. Maalaka Raddy,
Minister of Health & Family Welfare,
Government of Karnataka
MESSAGE
HIV/AIDS affects the most economically productive age group of 20-40 years.
At the state level it can adversely impact the economy and at the individual
level it can lead to increased poverty among the already poor sections of the
community. Its association with risky sexual behaviour has led to stigmatization
and consequent social impact. This socio-economic dimension makes it a
development issue.
Karnataka is facing perhaps its biggest challenge. The Government of Karnataka
has taken major steps in the last year to combat the HIV/AIDS epidemic. It has
integrated HIV/AIDS programmes with primary health care and all levels of
services. Targeted interventions through carefully selected NGOs have been
taken up in all the high prevalence districts and among all high-risk groups.
General awareness activities have been stepped up, using all forms of media,
including jathas and rallies. Blood banks have been modernized and testing
facilities expanded. Surveillance activities are being strengthened in all parts
of the State. STDs/RTIs are being treated at Family Health Awareness campaigns.
All sectors and departments are being involved.Along with prevention activities, facilities for effective management of
opportunistic infections are being extended to all government hospitals. Care
and support institutions are being opened in selected centres of the State.
I appeal to all sections of the society to join together to tackle the epidemic. Let
the epidemic not overtake us. The Government will leave no stone unturned
to ensure that all necessary measures are taken to prevent and control the
epidemic.
Dr. A. B. Maalaka Raddy
3
Dr. G. Parameshwar
Minister of State for Higher Education
& Medical Education,
Government of Karnataka
MESSAGE
The Challenge of HIV/AIDS needs to be faced boldly. College students are
especially vulnerable. Universities and Colleges should take full advantage of
the "University Talk on AIDS" and similar programmes to educate the student
community so that they behave responsibly. The medical community in general
and the medical colleges in the state have an important role to play.
Medical Colleges should take the lead in ensuring professional counselling and
testing services. There should be prompt treatment of opportunistic infections
in HIV infected persons. Hospital personnel at all levels need to be imparted
training. Surveillance centres at medical colleges should expand their activities
and publicly share information so trends of the HIV infection are widely
disseminated.
Measures to prevent mother to child transmission need to be introduced
immediately. The Pilot Project at Vani Vilas Hospital has already shown
encouraging results; we must ensure that new born children are not transmitted
the virus from their mothers.
Private medical institutions need to ensure there is no stigma or discrimination
in dealing with HIV infected persons. Anti-retro viral drugs have proved to be
quite effective in lowering the rate of progression of the infection and private
practitioners need to prescribe these drugs in a rational and cost-effective manner.
I am sure, that with the combined efforts of all sections of society, the HIV/AIDS
epidemic will be tackled effectively.
Dr. G. Parameshwar
4
The HIV/AIDS Epidemic : Situation at a glance
The India situation
The Global scenario
>
>
>
The HIV pandemic continues to spread rapidly.
>
HIV prevalence in India doubled over the last four
15,000 new HIV infections occurred every day in
years resulting in India having the highest number
2000.
of HIV infections in the world - 3.86 million Indians.
The spread is unequal around the world. 95% of
>
In Andhra Pradesh, Tamil Nadu, Karnataka,
the global total of infected individuals live in
Maharashtra, Manipur, Mizoram, Nagaland, HIV
developing countries.
prevalence has reached over 1 % among the adult
population.
Half of new infections are in young people below
In most other parts of the country,
the overall levels of HIV are still low, though male
25 years and 1 0% of the newly infected are under
migration,
1 5 years of age.
adverse gender norms, weak
infrastructure makes these states especially
>
Rates of infection are increasing in women. They
vulnerable to rapid spread of the infection.
now represent 43% of all those over 15 years living
with HIV/AIDS. 90% of infected women currently
live in developing countries.
>
89% of reported cases are in the sexually active
and economically productive age group of 18-40
years. Over 50% of all new infections take place
>
AIDS has risen to be among the top four killer
among young adults below 25 years. 21% of new
diseases worldwide - second among infectious
HIV infections are among women - a majority of
diseases. 3 million people died of AIDS in 2000.
whom do not have any other risk factor other than
being married to their husbands. Nearly 22,837
newly born children are infected and about 15,072
have died due to HIV/AIDS.
Adults and children estimated to be living
with HIV/AIDS as of end 2000
INDIA - a Rapidly Evolving HIV Epidemic 1986-1998
Age group
Male
0-14 yrs.
805
512
1317
15- 19yrs.
8756
3974
12730
30 - 44 yrs.
14224
3394
17618
> 45 yrs.
2146
551
25694
25931
8431
34362
Total
Female
Total
(upto Dec. 2000)
National Aids Control Programme : India Aids Cases
in India (Reported to NACO) (As on 31st March, 2002)
S.No
State
AIDS Cases
1
Andhra Pradesh
1316
2
Assam
3
Arunachal Pradesh
0
4
A & N Islands
20
5
Bihar
103
6
Chandigarh (UT)
470
7
Delhi
660
1986 - First case of HIV detected in Chennai.
8
Daman & Diu
1990 - HIV levels among High Risk Groups like Sex workers
and STD clinic attendants in Maharashtra & amongst injecting
Drug Users in Manipur reaches over 5%.
9
Dadra & Nagar Haveli
0
10
Goa
77
149
1
11
Gujarat
1465
12
Haryana
189
13
Himachal Pradesh
91
14
Jammu & Kashmir
1998 - Rapid HIV spread in the four large southern
states, not only in high risk groups but also, among the
general population where it has reached over 1% (up
to 3% in states like Andhra Pradesh).
15
Karnataka
1337
16
Kerala
267
17
Lakshadweep
1999 - india has an estimated 3.6 million HIV infected
persons
18
Madhya Pradesh
759
19
Maharashtra
7045
All Indian states have reported HIV cases
20
Orissa
Surveillance for AIDS cases in India
21
Nagaland
235
(Since inception 1986-31 st March 2002
22
Manipur
1095
23
Mizoram
20
24
Meghalaya
8
25
Pondicherry
157
26
Punjab
135
27
Rajasthan
394
28
Sikkim
29
Tamil Nadu
30
Tripura
31
Uttar Pradesh
506
32
West Bengal
831
33.
A. bad Mun. Corp.
1994 - HIV no longer restricted to high risk groups in
Maharashtra, but spreading into the general population.
1994 - HIV also spreading to the states of Gujarat and
Tamil Nadu where HRGs have over 5% HIV prevalence.
AIDS cases in india
Cumulative
Males
25931
8431
Females
34362
Total
Risk/Transmission Categories
No. of cases
Percentage
Sexual
29076
84.62
Perinatal transmission
816
2.37
Blood and blood products
1087
3.16
Injectable drug users
1107
3.22
History not available
2276
6.62
34,362
100.00
Total
2
0
82
4
16677
0
267
Total:
6
34362
HIV infection in India - State-wise prevalence - 2000
,
States
Group 1 - High prevalence States
(more thanl% of ante-natal mothers and over 5% of
STD patients positive for HIV)
Maharashtra, Tamil Nadu,
Karnataka, Andhra Pradesh,
Manipur & Nagaland
Group II - Moderate prevalence States
(5% of STD Patients and less than 1% of ante
natal mothers positive for HIV)
Gujarat, Goa and Pondichery
Group III - Low prevalence States
All other States
Nearly 85% of all new infections are through sexual
>
1
Group
.
The Karnataka scenario
transmission, 2-.-3% through perinatal transmission,
Karnataka has a total area of 1.92 lakh Sq. Kms.,
3.-2% through injecting drug use (IDU), and another
with a population of 52.7 million. The density of the
3rT% through blood transfusion and blood product
I infusion and others will constitute-6?4%.
■
I
population in the state is 275 per Sq. Km. The sex
ratio is 964 females for 1000 males. The crude birth
rate is 22 and the crude death rate is 7.5, both of
The worst is yet to come. The experience world
wide has been that unless the epidemic is fiercely
combated, HIV prevalence rates can rise to over
1 0% of the adult population in a very short span
of time.
which are well below the national average. The state
has 2624 health institutions, including 1676 primary
health centres. Sixty seven per cent of the population
is literate, with male literacy being 76% and female
literacy at 57%.
(Population and literacy figures are
taken from the 2001 census population totals.)
HIV/ AIDS and development
AIDS prevention and control measures were initiated
Globally HIV/AIDS is currently perceived as a
developmental issue rather than a mere public health
problem. This is because HIV/AIDS affects adults in
in the State in 1987 under the technical guidance of
Indian Council of Medical Research and one AIDS
Surveillance centre was established in the department
of Microbiology, Victoria Hospital, Bangalore Medical
the reproductive age group thereby changing the
College. The first HIV sero-positive individual was
demographic
structure
detected in the State during 1988 and the first AIDS
Consequently,
many African
of
the
community.
countries
have
experienced sharp declines in their National Income.
HIV/AIDS is also increasingly associated with poverty
case was also reported during the same year.
Subsequently, with financial assistance from
Government of India, the Blood Safety programme
commenced in 1989 and action initiated for
and is inseparable from issues such as unemployment
strengthening and modernization of the blood banking
and migration. Women are especially vulnerable to
system in the State.
HIV infection due to biological, social and economic
The State AIDS Cell was established in the Directorate
reasons. During the past decade HIV has also not
of Health and Family Welfare Services, in May 1992.
spared children who are increasingly affected and
The Cell implemented the World Bank assisted
infected by these virus, leading to increase in infant/
child mortality and morbidity
Phase-1 Project with financial assistance and technical
cooperation of the National AIDS Control Organisation
(NACO), Government of India during the period
1992-1998.
HIV/AIDS - Basic Facts
What is AIDS?
What happens when a person is infected with HIV?
AIDS stands for Acquired (A) Immune (I) Deficiency
When a person is infected with HIV, he/she does not
(D) Syndrome (S). The immune system defends the
show any external signs of the infection until the
body against infections and diseases. AIDS is a medical
progression to AIDS which can take anything from six
diagnosis for a combination of symptoms, which results
months to 10 years or more. On an average 50% of
from a breakdown of the immune system.
A virus
those infected take about 8 years to progress to AIDS.
This deficiency is
Till such time, he/she may continue to appear normal
causes the immune deficiency.
'Acquired' which means that it is obtained or received
and healthy but can infect others.
by a person and is something which does not ordinarily
exist within one's body. 'Immune Deficiency' means
Does HIV positive mean a person has AIDS?
that there is a deficiency in the immune system or
A person infected with HIV initially be perfectly healthy
that the immune system is weakened.
but will eventually develop AIDS.
AIDS is a
A person infected
'Syndrome' which means it is not one particular
with HIV is said to have AIDS when his/her immune
isolated disease but one which has a variety of
system is totally destroyed: he/she does not respond
symptoms leading to various disorders and a set of
to treatment and opportunistic infections invade his/
diseases.
her body.
What causes AIDS?
Can you identify an HIV positive person by
looking at his/her face?
AIDS is caused by a virus Known as Human (H)
It is not possible to do so.
Immunodeficiency (I) Virus (V). HIV weakens the body's
defence system or immune system.
How long does it take for the presence of HIV to
What is the immune system?
be revealed after the virus has entered the body?
In healthy individuals, infections are kept at distance
It takes about six weeks to three months to detect the
because of an array of defenders, which constitute
presence of HIV infection in the body.
the immune system in the body. The most important
What are the body fluids in which HIV is
constituents of the immune system are white blood
commonly found?
cells, which are present in the blood. These cells fight
HIV is known to be present in all the body fluids and
and destroy any infection-causing bacteria and viruses
blood. It is present in small (non-infective) quantities
that may enter the body, and thus protect the body
in body fluids other than semen, vaginal and cervical
against disease.
secretions.
How does HIV weaken the immune system?
HIV directly attacks the white blood cells.
How does a person become infected with HIV?
It enters
HIV is transmitted through the blood or sexual
and stays inside the basic genetic material (DNA) of
the cells.
secretions (semen, vaginal or cervical secretions). There
Then it multiples and attacks other white
blood cells.
are four ways or routes of transmission of the virus:
Slowly, the number of white blood cells
1.
in the body is reduced and the immune system is
Penetrative sexual intercourse with an infected
This is the commonest route of
paralyzed. HIV remains practically immune to counter
person.
attacks, since it hides inside the very cells that are
transmission.
2.
supposed to attack the viruses.
What does HIV positive mean?
The chances of
transfers HIV into the blood stream.
When an individual is said to be HIV positive, it means
3.
that the person is infected with HIV. However, the
Use of non-sterile, HIV infected or contaminated
syringes and needles. This is common among drug
person may not have AIDS, that is, he/she may not
users.
have developed the signs and symptoms of AIDS.
4.
c----------
Transfusion of infected blood.
getting infected are 90%. Infected blood directly
An infected mother to her unborn child. There is
a 30% chance that the child will be infected.
8
Modes of transmission in Karnataka.
•
Medical treatment in hospitals, in doctor's and
dental clinics and in all therapy situations where
The most common route of HIV is through
heterosexual sex. It accounts for nearly 80% of
the world's AIDS cases.
normal rules of hygiene and infection control are
maintained.
•
BREAK-UP OF SERO POSITIVES
Caring for people living with AIDS victims.
How can one protect oneself from AIDS?
Since a major route of transmission is sexual
intercourse, one can protect oneself from HIV/AIDS in
the following ways:
•
Have sexual intercourse with only one faithful
partner.
•
•
Use a condom in all types of penetrative sex.
If one uses needles, syringes or other instruments
that pierce the skin, make sure these are sterile.
Sero-
Route of Transmission
Percent
•
Make sure blood is tested before transfusion. Use
71.34
•
Avoid pregnancy if infected with HIV.
Positive
- Sexual
8,263
- Through Blood and Blood products
- Through infected syringes and Needles
- Perinatal Transmission
blood that is certified anti-HIV non-reactive.
642
5.54
16
0.14
174
1.50
- Others (including suspected ARC / AIDS)
2,488
21.48
As on 31-03-2002
11,583
100.00
Bd
How is the presence of HIV detected?
There are different tests to detect the presence of
HIV. The ELISA test was till recently, the simplest and
least expensive. There are now easy simple and rapid
(ESR) tests such as saliva and finger prick tests, which
enable almost immediate results.
All test results
Do all types of sexual intercourse carry the same
should be confirmed through 3 ELISA tests.
risk of transmitting HIV?
What do the tests for detecting HIV show?
HIV can be spread through unprotected sexual
The tests tell us whether antibodies against HIV are
intercourse. The ranking in order of risk is as follows:
•
Anal intercourse carries the highest risk.
present in the blood at the time of testing. However,
During
they cannot tell us whether the person can get infected
such an act, the possibility of wear and tear is great.
or not in the future. This means that even if the test
This provides an opportunity for the virus to enter
is negative, the person still has to take preventive
the body easily. Also, the risk of condom breakage
measures.
is high during anal sex.
•
What are the limitations of these tests?
Vaginal intercourse
Normally, the body requires six weeks to six months
How is HIV spread from a mother (infected with
to produce antibodies after the entry of HIV.
HIV) to her unborn child?
Therefore, if the blood is tested before antibodies have
Babies may acquire the virus from their mother while
been formed, the test results would show a 'false
still in the uterus, most commonly during the last three
negative'; i.e. antibodies are not detected as have
months of pregnancy, during labour and delivery, or
one more. This period is called the 'window period'.
through breast milk.
In such case, the test will have to be repeated after
How can you not get the HIV virus?
three months to confirm the presence or absence of
HIV cannot be transmitted by:
HIV.
•
Casual contacts such as kissing, shaking hands,
How did HIV originate?
sharing cups etc,
No one knows for sure about the origin of HIV. What
•
Donating blood.
matters is that it is now present in India and is
•
Masturbation,
fast spreading.
•
Using public toilets, swimming pools, community
from HIV.
showers, saunas,
9
One has to learn to protect oneself
Age & sex wise HIV positive cases in Karnataka
from 1987 to March 2002
Age & sex wise AIDS cases in Karnataka
from 1987 to March 2002
□ Male
■ Female
Age in Years
Age in Years
Phase-1 of the National AIDS Control Programme
testing centres, to ensure quality of TTD screening
(1992-1998)
needs to be implemented.
1.
Increasing voluntary
donation and retention of donors should be the single
Blood safety
most important agenda along with steps to ensure
Blood Safety was accorded top priority by Karnataka
correct rational and optimum use of blood collected.
and 10 zonal Blood Testing Centres were established
in the state during Phase-1. 52 Blood Banks, including
2.
37 in the government sector and 14 in the private
Apart from the surveillance centre located at the
sector were modernized.
Department of Microbiology, Bangalore Medical
College and Victoria Hospital in 1987, two additional
The Government of Karnataka has taken full
AIDS Surveillance centres were established in 1 992 at
responsibility for making safe blood available to
the Department of Neurovirology, National Institute
anyone who needs it. Karnataka has to meet several
of Mental Health and Neuro Sciences (NIMHANS),
challenges presented by the existing blood transfusion
Bangalore and at the Department of Microbiology,
services in order to ensure blood safety. Though there
Kasturba Medical College, Manipal.
are now a total of 120 licensed blood banks in
Sentinel
Surveillance was initiated in the State among STD
Karnataka today, there continues to be regional
patients and ante-natal mothers.
inequalities as well as difficulties in obtaining blood
at a few peripheral hospitals.
Surveillance
3.
Inadequate voluntary
blood donation has led to a large dependence on
NGO activities
The State has been fortunate to be endowed with
replacement donors. Another important challenge is
highly committed NGOs who have initiated and carried
the sub-optimal and irrational use of blood. A recent
out excellent work in various spheres of HIV/AIDS, some
study revealed that as much as 72% of adult
of which have been trendsetters for the entire country.
transfusions and 49% of child transfusions were
A glimpse of some of the NGO activities carried out
inappropriate.
in Phase-1 is provided below:
Therefore, there is a need for rationalization and
(i)
Intervention among Commercial Sex workers
centralization of blood bank services. Small blood banks
of Bangalore. Unlike in other metros and major
can act as blood collection centres, while component
cities in the country, Bangalore does not have
separation and screening for Transfusion Transmissible
organised "red light areas".
Diseases (TTD) can be done at bigger blood banks which
Bangalore has been carrying out HIV prevention
will ensure quality as well as economic viability.
programmes for sex workers in Bangalore since
An NGO from
1993. Similar work was also initiated by another
Education, training and cadre development backed
NGO in Belgaum District.
by evaluation and accreditation of the blood banks/
10
(ii) Care and Support:
Three NGOs have
established excellent networking with major
Government and private hospitals in Bangalore
resulting in the provision of high quality care and
support to people living with HIV/AIDS (PLWHAs).
6.
Training activities
The State AIDS Cell initiated training activities in 1 992
and has been carrying them out on a regular basis for
various categories of personnel, including District
Health and Family Welfare Officers and District
A Well
Surgeons, Faculty Members of government and private
Women's Clinic was established by an NGO in
Medical Colleges, STD Specialists, Medical Officers of
Bangalore. This clinic caters to women's
STD clinics and Paramedical Staff of all District Level
(iii) The Well Women's Clinic Concept:
reproductive health needs and focuses on early
STD Clinics, Faculty Members of Health and Family
detection and management of Reproductive Tract
Welfare Training Centres, Health care Providers,
Infections (RTI).
This is supplemented by
counseling services.
NGOs, Hospital administrators, Zilla Parishad
Members, Dental Surgeons, ESI Doctors, School Teachers,
(iv) Truckers programme: NGOs in Bangalore have
initiated an awareness and prevention programme for
truckers and their helpers at Bangalore and Mangalore
Truck drivers etc.
Training programmes
conducted during
2001-2002
since 1 994.
Training programme
(v)
4.
KNP+: The Karnataka Network for People Living with
Number
trained
HIV/AIDS (KNP+) was registered in September 1998
1. Govt. Dental College, Dental Surgeons
42
and is actively involved in advocacy for PLWHAs.
2. KIMS Hubli : Specialists Training
157
Strengthening of STD Clinics
3. Vani Vilas Hospital, Bangalore
STD clinics across the State in various districts have
been strengthened by providing drugs, better facilities
a) Specialists Training
218
b) Paediatricain Training
80
c) PMTCT Staff of Medical Colleges
40
for diagnosis as well as training of STD specialists and
para-medical
staff
in
HIV/AIDS
diagnosis,
management and counselling.
5.
4. College of Nursing : Staff Nurses
561
5. NIMHANS, Bangalore
IEC activities:
A large number of IEC activities were undertaken
a) Blood bank officers training
24
b) Blood bank technicians/Staff Nurses
33
c) EQAs programmes
32
They included those
d) EQAs programme VCTC
6
sponsored by the State AIDS Cell as well as those
e) AIDS Management / ART
23
during Phase-1 in the State.
sponsored
by NGOs.
These activities were:
development of TV spots and radio jingles, World AIDS
day and Voluntary Blood Donation day celebrations,
development and staging of street plays in regional
languages, media programmes in schools and colleges
6. Mysore Medical College, Mysore
Paramedical staff
41
7. School AIDS Education for NGO's
40
8. Dist. AIDS Nodal Officer/DHO's
10
by NACO at Hyderabad
and sensitization workshops conducted for elected
representatives and Zilla Panchayat members at the
district level.
An NGO in Bangalore has set up a
HOTLINE for telephone counselling.
9. Principal / Dean of Medcial Colleges
& Superintendents of major Hospitals
50
lO.Kasturba Medical College, Manipal
a) Medical Officers Training
118
b) Specialists Training
102
7.
The Karnataka State AIDS Prevention Society
Implication/Significance of the HIV/AIDS trend
(KSAPS) - The second in the country
in Karnataka
The State set up the Karnataka State AIDS Prevention
❖
Society (KSAPS) in 1997, the first to do so after Tamil
The number of HIV infected individuals is
showing a steady increase in the last ten years.
Nadu. The establishment of the Society has given a
fillip to AIDS prevention and control activities in the
❖
State.
The number of HIV infected women is on the
rise.
VULNERABLE POPULATIONS
1-2% of women attending antenatal
clinics are infected.
This is indicative of HIV
The marginalised sections of our society are most
infection in the "general population". Most of
vulnerable to HIV/AIDS and its consequences. Though
these women report sexual contact with a single
poverty is a factor, very often risk behaviour is related
partner - their husbands.
to other factors.
This points to the
urgent need for adoption of safer sex practices
Women
among all sections of the society.
Biological (physical), social, cultural, economic factors
❖
and gender inequalities make women more vulnerable
The rate of infection among STD (Sexually
Transmitted Diseases) clinic offenders is also
to HIV/AIDS.
increasing. This shows the high rate of infection
Children
among people with "high risk" behaviour. STDs/
In the coming years, as HIV infections increases, large
RTls need to be identified and treated and safer
percentages of children will be orphaned or infected
sex practices adopted.
by HIV themselves.
Adolescents
❖
Despite quite a high degree of awareness about HIV/
Number of deaths due to AIDS is on the rise. This
shows that the epidemic has progressed
AIDS, the knowledge is not translated into responsible
considerably. It calls for care and support services
(sexual) behaviour because of misinformation and
for people with HIV infection. This is essential to
myths and a feeling that "this will not happen to me".
improve the quality of life of people with HIV
Migrant workers and others
infection and to prevent transmission.
Who stay away from their homes and family for long
❖
periods of time are more vulnerable to HIV infection.
The number of children born with HIV infection is
Other vulnerable groups include resident of insitutions
on the rise as would be expected with increase in
such as jails especially because of a high incidence of
the number of infections in women. As there are
homosexual activity.
Studies carried out in various
effective drugs to control mother to child
parts of India have shown that STD clinic attendees
transmission, there is urgent need to identify and
have a high incidence of HIV infections (5 - 30%).
treat pregnant women who are HIV positive.
Commercial Sex workers
They are the most vulnerable group for HIV infection.
Phase-ll
In Karnataka, sex work is not organized like in
of
the
National
AIDS
Control
Programme : Current status
Maharashtra and Calcutta.
Phase -II of the National AIDS Control Project (NACP)
Alcohol Users / Abusers
was officially launched by NACO in December 1999.
Several studies in Karnataka and elsewhere have
This Phase is supported by World Bank assistance for a
found a significant link between alcohol use and abuse
period of five years from 1999 to 2004.
and sexual risk behaviour.
12
Broad objectives of the Phase - II AIDS Control
Mandatory Testing of Blood Units
Project in Karnataka
All blood units collected by all the blood banks in
(i)
To reduce the spread of HIV infection in the State.
the State by voluntary / replacement donation are
subjected to following mandatory tests to prevent
(ii) To strengthen the State's capacity to respond to
transmission of infectitious diseases:
HIV/AIDS on a long-term basis.
• HIV
• Hepatitis B
Specific project objectives
• Hepatitis C
•
To keep HIV prevalence rate below 3% in the adult
• VDRL
population in Karnataka.
•
•
• Malaria
To reduce blood borne transmission of HIV to less
Nearly 2,63,474 blood units were collected by all
than 1%.
the blood banks in Karnataka during 2001, out of
which nearly 5958 blood units were tested positive
To attain awareness level of not less than 90% among
for above tests, hence rejected.
the youth and others in the reproductive age group.
•
Apart from setting up of blood banks, blood
To achieve condom use of not less than 90% among
component separation facility, the programme
high risk behaviour groups.
aims at promoting voluntary blood donation,
Programme Components
training of Blood Bank Medical Officers and Blood
Component-I : Priority Targetted Interventions
Bank Lab Technicians of mandatory testing (HIV,
Hepatitis-B, HCV, VDRL, & Malaria), rational use
This includes interventions among high risk groups
of blood products, quality parameters, universal
involving non-governmental organisations including
precautions, prophylaxis drugs, and others.
condom promotion. The STD/RTI services will be
Karnataka State Blood Transfusion Council has
strengthened with continued support for existing 35
been established during July 1 996. Under NACP-
STD clinics.
II programme, NACO will continue to assist 52
Component-ll : IEC, Blood Safety, Voluntary
blood banks and 5 blood component separation
Counselling and Testing Centres
facilities. All together there are 120 licenced Blood
Banks are existing in Karnataka comprising of 31
a)
Information, Education and Communication
Government Blood Banks at Govt, hospitals, 5 at
activities are undertaken by utilising print media,
Government of India hospitals, Public Sector, and
electronic media and folk media to create
Autonomous institutions, 41 Private hospitals
awareness on HIV/AIDS/STI prevention and control
Blood Banks, 24 Private Blood Banks, and 19
in the community.
b)
Voluntary Blood Banks.
The Blood Safety programme is an important sub
c)
component under component-ll of National AIDS
The existing six Voluntary Counselling and Testing
Centres will be continued and in addition 22 new
Control Programme. It mainly focuses on complete
Voluntary
blood transfusion safety and reduction of HIV
Counseling and Testing Centres are
being established at District level hospitals with
transmission through blood and blood products.
facilities for counselling services and HIV testing.
Operationally the project interventions seeks to
This includes provision of salary for lab technician
achieve HIV transmission of < 1 % by the end of project
and counsellors including supply of consumables
period.
and equipment.
13
Component-Ill - Low cost AIDS Care and Support
Department will be continued as an ongoing
This includes establishment of low cost community care
programme including training of private doctors with
centre/hospices to provide care and support for
the involvement of IMA and ISM Doctors and Dentists.
terminally ill AIDS patients. The existing three low cost
Component-V : Intersectoral Collaboration and
care centres will be continued and new centres
established.
School AIDS Education programme
The major hospitals and district level
hospitals will be strengthened by providing medicines
The activity under this component will be taken with
for management of HIV/AIDS cases with opportunistic
the involvement of non-governmental organisations
infections etc.,
to ensure Intersectoral Collaboration among
Institutional
government and public sector undertakings including
Strengthening, Operational Research and
industries and factories on AIDS prevention and control
Programme
Research
&
Management,
Development
and
by way of social mobilisation and advocacy workshops.
Training
The school AIDS education will be planned at the District
Programme.
level with the involvement of District AIDS Prevention
The HIV sentinel surveillance will be continued at 18
Committee and Education Department in schools and
identified HIV sentinel sites (8 high risk groups - of
colleges.
STD clinic, Drug De-addiction centre and 10 low risk
High Prevalence Districts
groups - ANC clinics). HIV surveillance is taken up to
know the trends of infection over a period of time in a
The following Districts in Karnataka State are identified
particular group as per the NACO approved protocol.
as HIV high prevalence Districts:
The AIDS case surveillance and the STD surveillance
1.
Bangalore Urban
activities will be continued.
2.
Bellary
The monitoring and supervision of the implementation
3.
Belgaum
of various component activities will be taken up at
4.
Bijapur
District level and State level by KSAPS, this includes
5.
Chamarajanagar
The
6.
Dharwad
7.
Dakshina Kannada
8.
Gulbarga
9.
Mysore
operational increment cost and salary of staff.
feasibility study of AZT trial for prevention of mother
to child transmission intervention will be continued.
The training programme for Medical Officers,
Specialists, Staff Nurses and all category of staff in
1 0. Udupi
the Health & FW Department and Medical Education
14
Current situation of HIV/AIDS in Karnataka
Bangalore) and facilities in 22 new centres established
Surveillance activities for HIV infection were initiated
during 2002-03.
in the State in 1 987. As on the end of March 2002, a
Existing Voluntary Counselling and Testing
total of 4,65,988 samples have been tested for HIV
Centres (VCTCs) in Karnataka.
and amongst these 1 1583 found to be HIV positive.
1.
This gives a cumulative sero-positive rate of 24.90
per thousand samples tested.
Department of Microbiology, Victoria Hospital,
Bangalore.
2.
However, it must be
Department of Nuero Virology, NIMHANS,
Bangalore.
noted that cumulative sero-positivity rates can be
3.
highly misleading. Therefore, the annual increase in
Department of Microbiology, Kasturba Medical
College, Manipal,
HIV infection as determined by sero-surveillance has
4.
been analyzed from 1987 to 2000 and presented in
5.
the figure below.
Department of Microbiology, VIMS, Bellary.
Department of Microbiology, Karnataka Institute
of Medical Sciences, Hubli.
Rate of seropositivity
6.
(Voluntary Counselling & Testing Centres)
Department of Microbiology, Kasturba Medical
College Hospital, Mangalore.
ii)
Continuum of care
Strategies for the management of opportunistic
infections (Ols) need to be addressed as it improves
the quality of life of PLWHAs since investment in HIV/
AIDS care has important spin-offs for prevention, in
much the same way that prevention measures such
as voluntary HIV counselling and testing can result in
improved access to care.
and support programme is already reaping rich benefits
The current estimates of HIV infection in Karnataka
is 3 lakh cases.
from such investment.
HIV I AIDS epidemic is progressing at a rapid rate
in Karnataka especialy in the younger age groups.
Providing care and support to PLWHAs can break
through the denial about HIV by their talking with
Although the epidemic has spread to all the 27 districts
of the state, the density of PLWHAS at present seems
to be "relatively" more in ten districts.
friends and neighbours and reducing the discomfort
associated with the subject.
Moreover, it empowers
care providers to demonstrate in the community that
CARE AND SUPPORT
i)
Uganda, a developing
country, that has invested in a comprehensive care
Summary of trends
there is no reason to fear becoming infected through
Surveillance and Voluntary Testing
everyday contact and thus help dispel misguided
beliefs about HIV transmission. Above all, providing
Voluntary Testing coupled with counselling is a vital
diagnosis and treatment for opportunistic infections,
component of any care and support programme. The
especially tuberculosis and sexually transmitted
recent Karnataka experience during Phase-ll has indicated
diseases that are common among people with HIV,
that provision of Voluntary Counselling Testing Centres
also help decrease its spread among the general
(VCTCs) in the districts increases case detection - Bellary
population.
and Hubli-Dharwad districts are reporting HIV infection
In the area of care and support, KSAPS is largely
to a greater extent after VCTCs were established at
playing an advocacy role. KSAPS works with various
these districts in 1999.
nodal agencies consisting of NGOs who are involved
The State has decided to establish Voluntary
in specific activities that complement the overall
Counselling and Testing Centres (VCTCs) in each of
objectives of the state's AIDS prevention plan.
the 27 districts.
Six are already operational (two in
The
care and support team will link up to the various districts
15
with the help of sub-nodal agencies in the NGO,
and not independent of them. This would be followed
Government sectors from various districts, talukas and
up by setting up additional facilities in a phased
panchayats. KSAPS and the nodal agencies are now
manner at each district on a need-based basis.
taking measures to de-centralise services. KSAPS has
Opportunistic Infections
iii)
an integrated approach which encompasses the entire
spectrum of services, like medical, testing, psychological,
Tuberculosis is the most common Ol seen in PLWHAs
social, training of trainers, short stay/long stay homes,
and accounts for about 80% of all Ols. It is therefore
palliative/hospice core, various intervention and
important to integrate the Revised National TB Control
generalized awareness programmes, education/other
Programme (RNTCP) with the NACR
prevention activities including sensitization programmes.
iv)
Legal representation and advocacy are all incorporated
STD/RTIs are the most common risk factor for acquiring
as part of the care and support units. The Care units are in
HIV infection.
turn linked to other services within the health and
important component for the NACP To enable more women
Management of STD / RTI
STD/RTI management is therefore an
development sectors. KSAPS proposes to work closely with
and their partners to access STD/RTI facilities, integration
various nodal agencies to build capacity and consolidate
of NACP with the RCH program is vital.
the Bangalore Model of Care and Support.
implementation of such a strategy will be achieved
There is need to motivate and empower existing health
by addressing the following issues:
care facilities such as medical college hospitals/district
(a)
The
Providing training and integrating the syndromic
hospitals to treat Opportunistic Infections (Ols) by
management protocols for STD/ RTI into the RCH
providing support for management of Ols. To begin
training programme,
with, it is proposed to set up low cost Care and Support
(b)
facilities centred around a hospital in the high
prevalence districts within the next one year.
Using the RCH staff for disseminating HIV/AIDS
awareness and safer sexual behaviour practices,
These
(c)
facilities would be within the existing health care facility
Propagating the concept of "Well Woman Clinic"
based on the Bangalore model.
The NIMHANS initiative
A multidisciplinary group chaired by the Director, has been functioning at the National Institute of Mental Health and
Neuro Sciences (NIMHANS), since 1989. The following services are provided:
Clinical Services
Laboratory Services
•
Neurology - treatment of opportunistic infections
•
HIV diagnosis since 1989
•
Psychiatry - HIV in psychiatric and de-addiction patients
•
Sentinel surveillance since 1992
•
Neuro-surgery - surgical interventions
•
Development and evaluation of Testing Kits
•
Autopsies - largest series of HIV/AIDS autopsies
•
CD4 Counts
Training and Education
Counselling Services
Training health personnel
•
Pre and post, couple and family counselling since 1993.
•
•
Referrals from Hospitals and Care facilities
•
Development of educational materials
Risk reduction counselling
•
Advocacy
•
Phone: 6995157 / 6995128
Contact persons : Dr. V. Ravi, Additional Professor, NIMHANS
Dr. Jayashree Ramakrishna, Additional Professor, NIMHANS
E mail : vravi@nimhans.kar.nic
jramakrishna@nimhans.vsnl.com
16
•
Behavioural research
•
Networking
•
Consultancy
•
Members of Technical Resource Groups
v) Family Health Awareness Campaigns
2.
(FHAC)
Media-Corporate sector-NGO collaboration for
media plan and implementation
The tremendous success of the Family Health
The media plan needs to be a five-year plan
Awareness Campaigns conducted during the Phase-ll
sustained and supported by all the KSAPS
of NACP in the State, has provided insights into the
awareness activities, with collaboration with
benefits of such an approach.
professional media groups, corporate sector and
Therefore, KSAPS is
adopting strategies for "institutionalizing" this concept
NGOs.
as well as providing a modicum of continuity to enable
3.
integration into the existing Health and Family Welfare
Research Collaborations among institutes,
NGOs and KSAPS
structure. This is proposed to be achieved by providing
"Well Woman Clinic Services" at taluk level hospitals.
Closer collaborations need to be established
COLLABORATIONS
among research institutes, private research
agencies, NGOs and KSAPS to identify information
Large multi sector collaborations are needed for
needs for the next five years. While some research
upscaling and incresing coverage while maintaining
will continue to be empirical, specific research
quality of interventions. Some immediate areas
should be commissioned on securing the
identified for collaboration are:
knowledge based for evidence-based planning.
1.
Inter-State collaboration on migration
Action research should also be planned in institutes
Maharashtra, Andhra Pradesh, Tamil Nadu and
as 5-year perspective studies.
Karnataka - both governments and NGOsfrom these
4.
states - need to have close collaboration. This would
Partnerships in condom promotion, male
sexual health and women's reproductive
require migration mapping and evolving a
health
uniformity of approach across states. This should
draw upon work being done on cross-border
Collaboration among different stakeholders in
migration in Thailand and the North-East.
condom promotion is critical.
The condom
Prevention of Mother to Child Transmission (PMTCT)
Specialist, Microbiologist, Physician and Community
• Transmission of HIV from Mother to Child is one of the
Medicine Specialist.
principal source of infection among children of age less
than 15 years.
o During 2002-03 in districts where there are no Medical
Colleges, similar teams from district hospitals will be
• Sentinel Surveillance has revealed that the incidence of
trained.
HIV infection among pragnant women in Karnataka is
o In Karnataka, 12 lakhs pregnancies are estimated per year,
about 2.1%. As the infection raises in the community, risk
of Mother to Child Tranmission of HIV raises, hence PMTCT
26000 pregnancies are expected to be in HIV positive
program is on the priority programs of NACO.
women, out of which about 30% vertical transmission from
Mother to Child may result in 7800 Children being born
• Vani Vilas Hospital, Bangalore, is identified as centre of
with HIV infection.
excellence for imparting training in Karnataka.
® Encouraged with the results, PMTCT program has been
o Administration of Nevirapine, single oral dose to HIV
extended to all the Medical College Hospitals and District
positive pregnant women during labour and for the newborn
immediately after birth is expected to prevent transmission
Hospitals.
of HIV in about 30%.
• 21 teams from all the medical colleges have been already
o UNICEF has agreed in principle to bear the cost of drugs.
trained. Each team consists of Gynaecologist, Child
17
promotion collaboration in Tamil Nadu, which was
World Bank through NACO.
a collaboration between state managed APAC,
continue to be the main funding source, there
marketing and market research consultants,
are many multi-lateral agencies that have a rich
condom manufacturers and NGOs has proved to
experience of collaboration with AIDS prevention
Their expertise and
be a great success, raising Tamil Nadu's market
strategies across the globe.
share of condoms from 14% to 31% of the national
reservoir of case studies of what has worked and
total.
what has not, will be made use of to the maximum
extent.
Condom promotion has been the single most
over.
The entire group of UN agencies, for
example, can provide just the right support in areas
effective intervention in HIV prevention the world
of training, programme monitoring as well as
Aggressive condom promotion should be
advocacy. The state government will also continue
taken up through a variety of strategies. The state
to explore complementary bilateral funding
aims at increasing its market share of condoms
sources and look for collaboration with such
from 6% to 1 5% of the national total in the next
agencies.
two years.
5.
While this will
7.
Collaboration with women's movements and
Collaboration among NGOS
NGOs, doctors from major hospitals caring for
NGOs working with women
PLWHAs and the KSAPS have together recently
Involvement of women's movements, especially
constituted an informal forum called "AIDS Forum
women's Health advocates need a collaborative
Karnataka" (AFK) to facilitate monitoring of intervention
approach which is multi-agency and multi-sectoral.
activities. Similarly, several of KSAPS' partner NGOs
6.
Collaboration with multi-lateral agencies
Both Phases, viz.
have formed the Network for AIDS prevention. Such
Phase-1 & Phase-ll, of
kinds of networking need be strengthened and
Karnataka's programme has been funded by
supported.
HIV AND TUBERCULOSIS
♦
In India, there are an estimated 3.86 million persons are infected with HIV.
♦
In India, estimated that 50-60% of HIV positive persons will develop TB.
♦
l/3rd of global Tuberculosis (TB) cases are in India.
♦
Every year 20 lakh people develop TB in India, out of which, 8 lakhs are infectious.
♦
TB is the most commonest opportunistic infection in HIV positive persons.
♦
TB is the first manifestation of AIDS in > 50% of HIV + ves in developing countries.
♦
Even in HIV / AIDS patients, Tuberculosis can be cured.
♦
Treatment for TB is provided free of cost in all Govt, health care facilities.
♦
Curing TB in HIV/AIDS patients will improve quality of life, and prevent further TB transmission to
other family members.
18
Undid - Canada HIV/AIDS Project (1-CHAP)
The Canadian International Development Agency (CIDA), have come forward to
support implementing HIV/AIDS prevention project as a bilaterial funding agency
in the states of Karnataka and Rajasthan in the country. Their main focus is on
enhancing capacity development, epidemiological surveillance, targeted
interventions, prevention and control of sexually transmitted diseases, care and
This project will also take up executing
demonstration projects for HIV/AIDS, focusing mainly on the northern and rural
support and operational research.
parts of the state. For designing the project, CIDA has identified a Canadian Agency
comprised of the following organisations :
1.
University of Manitoba (Winnipeg, Canada)
2.
Pro-action - Partners for Community Health, Inc. (Montreal, Quebec)
3.
Mascen Consultants, Inc. (Ottawa, Canada)
The project will be implemented initially for a period of five years. The Government
of India and Government of Canada officially signed and approved the project on
7th February 2001.
The CIDA Project has two main components
1.
Capacity building
2.
Model Programming (Demonstration Project)
As a first step in Project implementation, an intensive consultative process has been
undertaken with KSAPS and key implementing partners at the state and district levels, to
identify the activities and the priorities for the Project. In addition, a detailed first Annual
Work Plan has been developed that will set the course for the Project activities over the
coming year. This Work Plan has been presented to the Project Steering Committee for
final approval. On this basis, a joint Action Plan for Karnataka State will be developed
through partnership with KSAPS. A key component of l-CHAP's Action Plan is to develop
innovative HIV prevention and care programs for rural populations, especially in Northern
Karnataka. In this regard, community-based programs are beging initiated in Dharwad
and Bagalkot Districts, in collaboration with local government and non-governmental
organizations and institutions.
19
Key Action Points in the HIV/AIDS Management Strategy of Karnataka
1.
Integration of HIV/AIDS program with the Health
8.
Focus on youth, both in the organized sector (such
and Family Welfare Services - Eg. Revised National
as schools, colleges etc.)
TB Control Program (RNTCP) and Reproductive and
sector.
and the unorganized
Child Health (RCH), as well as general health care.
9.
2.
Capacity building at various levels in the State -
Care and support programmes to focus on
treatment of opportunistic infections (Ol's) and
KSAPS , Departments of Health & Family Welfare,
management of sexually transmitted diseases
Education , Women and Child Development and
(STDs) and reproductive tract infections (RTFs).
NGOs.
3.
Condom promotion within the State through multi
10.
Providing continuum of care.
11.
Risk reduction among alcohol dependents.
sectoral collaboration involving KSAPS-NGOs and
condom manufacturers - Market Research
Agencies.
4.
5.
12.
Involvement of People Living With HIV/AIDS
A comprehensive media campaign for awareness
(PLWHAs)
utilizing professional agencies.
programmes.
Shift in emphasis by focusing on the general
13.
population, along with continuing to concentrate
in
management
of
HIV/AIDS
Inter-sectional co-ordination within Government
departments and agencies.
on targeted interventions (Tl's) among "high risk"
14.
groups.
Decentralization from KSAPS to districts. Launching
of district action plans in all the ten high prevalence
6.
Strengthen and establish State-Private sector
districts.
collaboration with NGOs, private medical
institutions and professional bodies such as IMA,
15.
Set up monitoring and evaluation system.
FOGSI etc.
7.
16.
Establish Voluntary Counselling and Testing
Create a specialized cell to address legal and
ethical issues.
Centres in all districts.
20
TABLES
Table 1: Approved Action Plan of NACO and
Expenditure by
KSAPS froml.4.2001 to 31.3.2002.
(Rs. in lakhs)
Approved Action
Plan of NACO for
the year 2001-2002
Component
Total of Component
wise Expenditure from
1.4.2001 to 31.3.2002
Component -1
Priority Interventions
199.45
126.39
Component -II
Preventive Intervention for
General Community
613.99
545.19
Component -III
Low cost AIDS care
123.80
59.56
Component -IV
Institutional Strengthening
136.37
1 15.73
Component -V
Inter-sectoral Collaboration
10.00
-
1083.16
856.87
Total
Table 2 : Year-wise blood samples screened for HIV +ve
Year
Blood samples found
Blood
Samples
HIV + ve
1987
913
1988
2,264
1989
1990
Death due to
AIDS
%
AIDS cases
0
0
0
0
6
0.27
2
2
25,928
32
0.12
1
1
48,348
58
0.12
1
1
1991
66,828
86
0.13
1
1
1992
1,02,336
168
0.16
2
2
1993
76,237
868
1.14
9
9
1994
24,209
425
1.75
15
13
1995
11,583
439
3.79
12
12
1996
8,877
697
7.85
22
7
1997
15,452
847
5.48
58
17
1998
15,912
1,023
6.43
44
12
1999
16,702
1,319
7.90
200
20
2000
20,490
1,965
9 59
446
19
2001
24,051
2,900
12.06
541
27
5,858
750
12.80
88
3
4,65,988
1 1,583
-
1442
146
March 2002
Total
21
Table 3 : District-wise HIV+ve cases, AIDS cases.
Death due to AIDS in Karnataka
SI.
No.
Division /
Districts
March 2002
HIV +ve
AIDS cases
Death due to
AIDS
BANGALORE DIVN.
1.
Bangalore ( U )
3707
251
2.
Bangalore ( R )
261
15
5
3.
Tumkur
227
28
2
4.
Shimoga
220
57
3
5.
Chitradurga
148
14
2
6.
Davangere
61
24
0
7.
Kolar
234
28
4
149
15
5
8
3
0
5
36
MYSORE DIVN.
8.
Mysore
9.
Chamarajnagar
10.
Mandya
341
36
11.
Mangalore
917
19
9
12.
Udupi
709
222
14
13.
Madikeri
16
4
1
14.
Chikmagalur
110
24
3
15.
Hassan
141
16
2
BELGAUM DIVN.
16.
Belgaum
141
19
1
17.
Bijapur
130
3
0
18.
Bagalkote
52
13
1
19.
Dharwad
1043
283
18
20.
Haveri
no
29
1
21.
Gadag
107
37
1
22.
Karwar
267
83
7
3
GULBARGA DIVN.
23.
Gulbarga
74
7
24.
Raichur
206
21
5
25.
Bidar
8
2
2
0
26.
Bellary
1293
50
27.
Koppal
79
12
0
KARNATAKA TOTAL
10,759
1315
130
Other States
808
134
12
Foreigners
16
4
4
GRAND TOTAL
11583
1442
146
1.
2.
22
Table 4 : HIV Sentinel surveillance, Karnataka
Period of survey : from
SI.
No.
Name of Sentinel Site
01-08-2001 to 31-10-2001
Sentinel
Group
Number
Tested
Number
Positive
%
Positive
STD
250
37
14.80
STD
250
33
13.20
Kasturba Medical College,
Mangalore
STD
250
60
24.00
Karnataka Institute of Medical
Sciences, (K.I.M.S.) Hubli
STD
250
41
16.40
5.
District Hospital, Belgaum
STD
250
58
23.20
6.
District Hospital, Gulbarga
STD
250
29
11.60
7.
Vijayanagar Institute of Medical
Sciences, (VIMS), Bellary
STD
250
41
16.40
Hospital, Bangalore
1.
Victoria
2.
K. R. Hospital,
3.
4.
Mysore
8.
NIMHANS, Bangalore
IVDC
250
5
2.00
9.
District Hospital, Chamarajnagar
ANC
400
11
2.75
10.
Vanivilas Hospital, Bangalore
ANC
400
8
2.00 '
11.
District Hospital, Hassan
ANC
400
4
1.00
12.
District Hospital, Udupi
ANC
400
3
0.75
13.
District Hospital (Women &
Children Hospital) Davangere
ANC
400
5
1.25
Karnataka Institute of Medical
Science (K.I.M.S.) Hubli
ANC
400
4
1.00
15.
District Hospital, Bijapur
ANC
400
13
3.25
16.
District Hospital, (VIMS), Bellary
ANC
400
1
0.25
17.
District Hospital, Raichur
ANC
400
11
2.75
18.
District Hospital, Bidar
ANC
395
2
0.50
19.
Karnataka Institute of Medical
Sciences (K.I.M.S.) Hubli
ANC
15-24
Year
400
00
0.00
14.
23
NGO Partners of Karnataka State AIDS Prevention Society
SI.
No.
1
NameoftheNGOs
Target Group
Contact person
Telephone No.
Tele Fax
Truckers
Dr. Surya Prakash
2291738
2223857
Migrant Labourers
Mr. Sudha Guru
5351756
5551086
Migrant Labourers
Mr. Bhagvan Das
0824-431215
437731
Mr. Vijaykumar
5461920
5461920
Prisoners & CSWs
Ms. Santosh Waz
3332564
3430155
Street Children
Fr. Robinson
6524138
2286572
Sex Workers
Ms. Sangamitra
Iyengar
2238297
2993710
MSM& Transsexuals
Ms. RenuApacnu
2860346
Migrant Labourers
Ms. Harini Kakkeri
3223669
Kalmutt Building, Tikare Road, Dharwad.
Truckers
Ms. Pankoja
0836-744196
Karnataka Network for PLWH/A,
PLWHA
Mr. Elango
2120409
2120410
Telephone Counseling
Dr. Glory Alexander
5480548,5481097
3333408
Migrant Labourers
& Slum People
Dr. Hilda Royoppa
432682
-
Ms. Sunanda Tolabandi
28352-57136
Bhoruka Charitable Trust,
C/o. Transport Corporation of India Ltd.,
No. 57/58,2"°’Cross Kalasipalayam New Extension,
Bangalore-560 002.
2
Gramaswarajya Samithi,
Ullalu, Kengeri Uponagaro, Kodigenahally Panchayat,
Yeshwanthpur Hobli, Bangalore
3
Citizens Alliance for Rural Development & Training Society,
Shanti Sudan, University Road, Thokottu,
Mangalore-574 183.
4
Society for People's Action for Development,
Flat No. 1 /B, Orient Manor, 15, High Street,
Opp ITC Factory Gate, Cooke Town, Frazer Town,
Bangalore.
5
Janodaya Trust,
No. 3, Marappa Block, J.C. Nagar, Bangalore-560 006.
6
Bangalore Oniyavara Seva Coota (BOSCO),
7
Samuha-Samsraksha,
No. 91, 'B' Street, 6h Cross, Gandhinagar, Bangalore-560 009.
No. 268,111 Main, Defence Colony
HAL 2nd Stage, Bangalore-560 038.
8
Commercial
Sex Workers
Jagruthi,
Jyothi Complex,
C-3,2'° Floor, 134/1, Infantry Road, Bangalore-560 001.
9
SURAKSHA,
No. 461,1’’ Floor, 10 Block, 3d Stage,
Basaveshwamagar, Bangalore-560 079.
10
11
Karnataka Integrated Development Services (KIDS),
No. 113,1 Floor, 15th Cross, 8th Main,
Wilson Garden, Bangalore-560 030.
12
13
Asha Foundation, RB. No. 2407,Bangolore-560 024.
Prajna Counselling Centre,
Falnir Road, Kankanadi, Mangalore.
14
Ujwala Rural Development Service Society,
Commercial
Naresh Anand Nivas, Jadar Galli,
Sex Workers
Bijapur-586104.
15
16
Truck Workers Welfare and Charitable Trust,
No. 36, Pampamahakavi Road,
Chamarajpet, Bangalore.
Truckers
Mr. Chenna Reddy
6678030
6678526
Bhoruka Charities,
Truckers
Mr. Krishna Madhav
2272271,8510291
Truckers
Mr R.M. Patil
08332-84678
Mohaveer Hospital, 119D, 14/A, Bamboo Bazaar,
New Sayyaji Rao Road, Mysore-570 021.
Care & Support
Dr. Mothi
493985
510688
Freedom Foundation,
Care & Support
Mr. Ashok K. Rau
5440134,
5449766,5440135
2215513
8510365
48, Lavelle Road, Bangalore-560 001.
17
Belgaum Integrated Rural Development Society,
Nagonur, Dist. Belgaum.
18
19
Asha Kiran Charitable Trust,
180, Hennur Cross,
Bangalore-560043.
20
Snehadaan,
Care & Support
Br. Luca
Fr. Jayan
Care & Support
Mr. Eugene Rent
Caremelaram Post, Saqapur Road, Ambedkar Nagar
2215513,8439516
Bangalore-560 035.
21
Snehasadan,
Mulur Village, Kinni Kambli Post,
0824-213959
0824-211470
Via Mangalore.
22
Freedom Foundation
Bellary Project
23.
Freedom Foundation
Commercial
Sex Workers
Care & Support
Udupi Project
24
Mr. Ashok K. Rau
5440134
5449766,5440135
Tele Fax
5449766
HIV/AIDS high prevalence
districts m Karnataka
The Red Ribbon
The Red Ribbon is the
international symbol of AIDS
awareness.
It is worn to demonstrate care
and concern for HIV and AIDS.
It is also a symbol of hope that
the search for a vaccine and
cure to halt the suffering will
be successful.
Karnataka State AIDS Prevention Society
4/13-1, Crescent Road, High Grounds, Bangalore-560 001.
Phone: 2201237/38.
E-mail: ksaps@bgl.vsnl.net.in
Designed & Produced by Avanli Communications, B'lore.
It can be worn on any day of
the year but especially on
World AIDS Day - December 1.
That day, throughout the world
people wear the red ribbon to show
their support to the cause of HIV/
AIDS prevention.
NACO..
Page 1 of 3
>15-- 2-p—
2 ] About HIV/AIDS
Speeches of PM/MOM Indian Scenario
organization profile
Global Scenario
Ask the Doctor
Site Map
Announcements
Related Sites
Letter from Pro.Dlr
SACS
HIV/AIDS Indian Scenario
HIV/AIDS Surveillance in India
(as reported to NACO)
As on 31st May, 2003
AIDS CASES IN INDIA
Cumulative
MALES
39137
FEMALES
13618
1028
Total
52755
3559
This Month
2531
RISK/TRANSMISSION CATEGORIES
Percentage
No. of
cases
Sexual
45131
85.55
Perinatal transmission
1443
2.74
Blood and blood products
1389
2.63
Injectable Drug Users
1304
2.47
History not available
3488
6.61
Total:
52755
100.00
Age group
Male
Female
Total
2015
0-14 yrs
1243
772
15-29 yrs.
12159
6262
18421
30 - 44 yrs.
22733
5829
28562
> 45 yrs.
3002
755
3757
Total
39137
13618
52755
file://A:\N A C 0 .htm
6/7/03
N A CO..
Page 2 of 3
S. No.
State/UT
AIDS Cases
1
Andhra Pradesh
3707
2
Assam
171
3
Arunachal Pradesh
0
4
A & N Islands
27
5
Bihar
152
6
Chandigarh (UT)
710
7
Delhi
801
8
Daman & Diu
1
9
Dadra & Nagar Haveli
0
10
Goa
171
11
Gujarat
2587
12
Haryana
271
13
Himachal Pradesh
112
14
Jammu & Kashmir
15
Karnataka
1690
16
Kerala
267
17
Lakshadweep
0
18
Madhya Pradesh
996
9234
2
19
Maharashtra
20
Orissa
82
21
Nagaland
329
22
Manipur
1238
23
Mizoram
49
24
Meghalaya
8
25
Pondicherry
157
26
Punjab
231
27
Rajasthan
702
28
Sikkim
29
Tamilnadu
30
Tripura
6
31
Uttar Pradesh
921
32
West Bengal
930
33
Ahmedabad M.C
267
34
Mumbai M.C
2261
8
24667
Total:
52755
LJ
H
A
file://A:\N A C O .htm
HO,
6/7/03
NACO..
Page 3 of 3
National Aids Control Program 11 Speeches of PM/MOH 11 NACO Officials 11 State AIDS Control Societies 11 About HIV/AIDS 11 Indian Scenario
11 Global Scenario
Ask the Doctor 11 Announcements 11 Letter from the Project.Director 11 Feedback 11 Sjte.Map 11 Related Sites 11 Newsletter
file://A:\N A C 0 .htm
6/7/03
“CIRCLES OF HELP”
A Practical, Relevant, Do It- YourselfApproach
Practicing HIV/AIDS care in Karnataka
Resource mapping for different types of services in public,
voluntary and private sector
Prepared by Dr Rajkumar Natarajan, MPH
INTRODUCTION
Human immunodeficiency virus (HIV) is an epidemic causing disease and
death across the globe. Since it is global, HIV can be called a pandemic.
AIDS has already taken a terrible human toll, not only among those who
have died but also among their families and communities. Short of an
affordable cure, this toll is certain to rise. Ninety percent of HIV infections
are in developing countries, where resources to confront the epidemic are
most scarce. AIDS is clearly taking an immense and growing human toll.
The disease is catastrophic for the millions of people who become infected,
get sick, and, in stark contrast to the recent hopeful news of treatment
breakthroughs, die. It is also a tragedy for their families, who, in addition to
suffering profound emotional loss, may be impoverished as a result of the
disease. Because AIDS kills mostly prime-age adults, it increases the
number of children who lose one or both parents; some of these orphans
suffer permanent consequences, due to poor nutrition or withdrawal from
school. Primary prevention of infection in young adults would result in
parents living longer and there being fewer orphans and a well functioning,
appropriate, and accessible Voluntary counseling and testing service is very
essential for a successful Mother to child transmission prevention (1).
Numbers cannot begin to capture the suffering caused by the disease. Each
infection is not only a personal tragedy causing human suffering, but also
hampers the economic growth through diversion of investments, deficit
creating pressures on public resources, and loss of adult labour and
productivity. It was estimated that in the 1990s AIDS reduced Africa’s per
capita annual growth by 0.8% (2). In low-income countries in particular,
many urgent problems compete for scarce skills and resources.
In India, it is difficult to estimate the exact prevalence of HIV because of the
varied cultural characteristics, traditions and values with special reference to
sex related risk behaviors. It is no different in Karnataka, the official figure
shows 300,000 people infected with HIV that causes AIDS. With over 1% of
its adult population estimated to be HIV positive, Karnataka joins the other
high prevalence states like Andhra Pradesh, Tamilnadu, Manipur and
Nagaland (3). The prevalence of the infection in all parts of the country
highlights the spread from urban to rural areas and from high risk to the
general population. Migration of labor, low literacy levels leading to low
awareness, gender disparities, prevalence of sexually transmitted diseases
and reproductive tract infections are some of the factors attributed to the
spread of HIV/AIDS. HIV infection and AIDS are still associated with high
degree of discrimination and stigmatization. The implications of a positive
test go well beyond those related to physical and mental health and may
involve the loss of employment, medical and social benefits, friends, family
and freedom of movement.
All the estimates of illness prevalence are mere estimates with no accuracy
with very limited HIV testing facilities available. Most of these people will
not have the symptoms but they will eventually have them over a period of
time. A large majority of them do not know that they have HIV infection but
they can pass the virus to other people. Although the HIV sentinel
surveillance data has been primarily used for monitoring the trends i.e. to
assess how rapidly HIV infection increases or decreases over time in
different groups and areas, it can also provide an estimate of the total burden
of HIV infection in Karnataka. Sentinel surveillance were taken up in 14
sites from 1st August to 31s' October 1999 and 17 NGOs were funded by
Karnataka State AIDS Prevention Society between 1999 and 2000 (4).
Currently there are 6 voluntary counseling and testing centres (VCTC) in the
State and an unfulfilled promise of having additional 23 VCTCs by
August2001 (5).
In the WHO booklet, 1998, a step-by-step approach has been outlined for a
comprehensive HIV/AIDS care with voluntary counseling and testing as an
entry point in the continuum of comprehensive care, pre and post test
counseling, partnership building between providers (clinical, social, support
groups) etc (6). But, scarce resources for testing, counseling and care
providers is compounded by the fact that there is an absence of
comprehensive information on access to help. There is an urgent need to
information expressed by various groups including the PLWAs in
Karnataka, the KNP+ (7). Time and again there has been a lot of stress
placed on the need to build and improve linkages and referral among
HIV/AIDS services, organisations and other services, which would benefit
the PLWAs. There is also an emerging need for an effective networking
among NGOs to be more collaborative than competitive in this fight against
HIV/AIDS. There are some NGOs, who are extremely committed, there are
also some new NGOs that have been created with increased flow of money
and do not implement what they promise (8).
The access to information, a collaborative effort from every sector with
potential and committed partners to tackle this epidemic is very important
before this becomes a dangerous public health problem.
Community Health Cell (CHC) & AIDS
CHC is a community health professional resource group involved in
promoting the community paradigm in health action, training, research,
policy, action and advocacy on key public health problems in the State of
Karnataka and in the country. Over the past few years, CHC has been getting
involved in the HIV/AIDS issue incrementally.
• Dr. Thelma Narayan (TN) and Dr. CM Francis (CMF) have supported
CHAI (Catholic Health Association of India) to evolve a HIV/AIDS
policy for their Institutional members.
• TN is member of CIATF (Caritas International AIDS Task Force) that
has been exploring the social challenges of HIV/AIDS and the role of
faith based NGOs and others.
• CHC team members Dr. James P J and Dr. Deep Joseph have
provided technical support to AIDS hospices in Bangalore- Snehadan
and Ashakiran.
• The CHC library and documentation center produced a bibliography
of Resources and Information on AIDS in 1994 as a special
preparation for the “Consortium on formulation of CHAI policy on
AIDS”.
• TN attended the preparatory and final meeting of the UN General
Assembly Special Session on AIDS in May-Jun 2001 at UN- HQ in
New York.
• CHC has been supportive of AIDS Forum Karnataka as a member of
civic society and participated in the campaign and training
programmes.
• CHC has been on the governing body of INSA- that has been involved
with HIV/AIDS related training programmes in schools and colleges
for years.
Objective
The main objective is to provide information in the form of a resource
directory about the existing facilities for test, counseling and care
throughout the State of Karnataka.
Holistically speaking, the goal is to help all people living with HIV and
AIDS develop the ability to make the best of their fight with HIV disease, and
to provide them with the invaluable tools of knowledge and power.
Methodology
The resource directory will compile a list of all the Organisations and
voluntary care givers, testing centers in public, voluntary and private sectors
providing service at different levels in Karnataka. The resource directory
will contain information on professional organisations, semi-professional
and non-professionals.
Background
The “Circles of help” is a resource directory with a view to include public,
voluntary and private organisations and individuals who have interest in, or
activities specifically related to HIV/AIDS. The primary intent of the
resource directory is intended for use as a reference to individuals seeking
HIV/AIDS services and providers. The directory will also provide
information to Doctors and other health workers to identify the major signs
(WHO classification for HIV/AIDS) in the form of a flow chart. The
resource directory will hopefully help individuals and communities by
bringing people and services together through information, referral,
counseling and training.
The resource directory will be broadly categorized as:
■ Diagnostic facilities
■ Counseling centers
■ Care givers: includes health care facilities (hospitals, nursing homes or
health centers in public, private or voluntary) and NGOs.
■ Health education providers
■ Human rights activist and lawyers
■ Internet resources and AIDS- Educational materials
■ Self help groups (PLWAs), groups involved in Rehabilitation and income
generation activities for those infected with HIV.
The resource directory is expected to serve as a useful handbook for many
groups of people, for example:
Individuals suspected to have acquired HIV infection or tested positive for
HIV.
Doctors (public, voluntary or private), nurses and other health workers in
rural and urban areas who may recognize the symptoms early or direct the
suspected to the nearest testing facility.
The testing centers may use it as a useful tool to guide individuals to pre and
post test counseling and care.
Networking and Information exchange opens up avenues for new ideas,
contacts, information and support among NGOs or NGOs and Government.
For instance, Organisation working with Women and Children may
approach other organisations working on children of parents with HIV/AIDS
for assistance or support.
Community health workers, Schools and colleges may find it a useful
resource to contact organisations providing education and training etc.
“Circles of help” believes that a well-informed person is better able to
gain access to the full range of available treatment options and resources
and is better equipped to make decisions.
Budget for 3 months
Funding Required
, Identifying care anc[ service providers in private,
public and voluntary sectors- Funds required for
local travel and other ways of identifying potential
partners in other parts of Karnataka. It may also
be necessary to have a few persons to collect
information from outside Bangalore
a)Local travel
0
@ Rs 100 a day
5 days a week
Out station @
Rs 7000/ areax7
00
Rs
Rs 4 9 0
b)Allowance for
Rs
0/
Identified person i.e.
District Volunteer
(under miscellaneous)
@Rs 2000/ month
a)Telephone
@10 local calls & Rs
0
one STD call a day
(Rs 1.50 local
& Rs 15 STD)
b) Others. Fax,
Rs
00
postage etc @
Rs 500/month
Stationary and
00
Secretarial help @
Rs 1000/ month
Part-time
6 00
Rs
6 00
18 0
1 5
40
, Communication (Telephone, Fax, postage,
photocopying etc), Office Support to Collate the
information, ensuring Completeness and avoiding
duplication & Preparation of Manuscript.
, Funds for two (half a day-50 persons approx)
meetings jn Bangalore to evolve an informal
network of sharing, learning and reviewing the
draft manuscript before publication.
D Based on availability (may not incur any cost)
, Printing And Publication
@ Of Rs 20 per copy.
Numbers based on infra structure of health care
In Karnataka (8) and (9).
1. Primary health centers (PHCs)
1676
2. Community health centers (CHCs) 252
3. Sub-centers :
8143
4. Government Hospitals:
Includes District, teaching,
Major specialized, General &
Maternity.
177
5. Non-Governmental:
Includes Individual, Partnership,
Charitable trust, Registered
Society, Religious Mission and
Limited Company.
1709
6. Other Systems of Medicine:
Includes Ayurveda, Unani,
Homeopathy, Nature cure,
yoga and Siddha
7. NGOs
93
500
Advocacy:
Well-designed Posters to promote
the resource directoryOnly to government and
Non- governmental hospitals.
(1709+177+extras)
3000
Distribution of t]le resource directory among all
PHC's.CHC's,Subcentres, district hospitals and private
practioners (Identified through IMA and other sources)
through a proper delivery system to ensure promptness
and reliability.
Reference
1. Marie-Louise Newell. Prevention of mother- to-child transmission ofHIV: Challenges
of the cun-ent decade- International Journal of Public Health, 2001,79-12, 1 141.
2.Rene Loewenson and Alan Whiteside. Background paper for the United Nations
Development Programme for the UN General Assembly, Special session on
HIV/AIDS, 25-27 June 2001,9.
j.Sanjav Kaul.The Challenge of HIV/AIDS: Karnataka’s response, Madhyam, june
2001.26.57.
4.Karnataka State AIDS Prevention Society. Status report of Second National AIDS
control Project, 1999-2000.
5.Karnataka State AIDS Prevention Society. Karnataka’s response to HIV/AIDS,
August 2001, 15.
6.Jai P. Narain, Clement Chela, Eric Van Praag. Planning and Implementing
HIV/AIDS programmes: A step-by-step approach. WHO Project: ICP OCD 041,
December 1998, 3.
7.Elango (KNP +). Conference address, State level workshop on HIV/AIDS, 2000,
Bangalore.
8.Thelma Narayan. An overview of HIV/AIDS and the response to the Epidemic in
India. The Carits International Task Force on HIV/AIDS, Rome, 13-15"’ April, 2000.
9.State Family Welfare Bureau (UNICEF). Selected Indicators of Population and
health, Jan 2001,62-65.
10.Final Report. The Task force on Health and Family Welfare, Government of
Karnataka. Aprn 2001,22-30.
M.S.. F.I.C.S.
CANCER &. GENERAL SURGEON
Behind KSRTC Guest House, Garden Road, GULBARGA - 585 102
Ph.: 08472 - (H) 20671 - (R) 30900 - E-mail : sharad_mt@vsnl.com
®
President, Rotary Club of Gulbarga (2001-2002)
o
R.I. DI st. 3160, Chairman, AIDS Awareness
o
Asst. Professor of Surgery, M. R. Medical College, Gulbarga
o
Treasurer, ASI - Karnataka State Chapter - 2001-2003
Government of Karnataka - Health Policy on AIDS: Views
AIDS has received good attention from the Government in last 18 months only, when
compared to the thought given earlier.
This has given dividends. AIDS Awareness dissemination has increased many folds.
The inherent propensities to spread like a wildfire in Heterosexual transmission; and
the gratifying results in terms of Awareness makes it mandatory to give a considered
thought to reassess the existing Health Policy and emphasize a sustained campaign
against AIDS.
HIV has become a public health problem. One among every 100 people in Karnataka
are estimated to be infected with HIV. Villages and cities are wiped off in Africa due
to AIDS. That situation would not be far away in India.
The disease is no longer restricted to the high-risk group e.g. Commercial Sex
worker, Lorry drivers and I.V drug abusers. Glaringly, disease has made inroads to
the middle class households.
New targets need to be adopted for a campaign to halt and start reversing the AIDS
epidemic.
The figures given out by the Karnataka State AIDS Preventive society in its monthly
update on HIV infection in Karnataka is abysmally low. The No. Of HIV positive cases
in the month of June is given to be 296 and in a period of 14 years from 1987 to May
2001 it is slated to be 9010. It's just unacceptable!
Comparison of African and Indian Status
India
Developing Country
Africa
Developing country
Heterosexual mode of transmission
Heterosexual mode of transmission
"Zimbabwe considers double burial as AIDS bites hard." It has one of the highest
rates of infection the world, with one in five people believed to have the virus that
causes AIDS. That situation is not too distant for India needs prominence.
It's leadership that will ultimately be the driving force that will reverse and
eventually halt the devastation of this epidemic.
The declaration at the last September's U. N. Millennium summit, made a
commitment to stop the spread of HIV/AIDS by 2015.
Many are divided on what should get the lion's share of funds and attention treatment or prevention.
Key objectives:
1. To prevent the disease spreading further, above all by teaching young
people how to avoid it {15-24 years}.
2. We must stop the cruelest infection of all - those from mother to child.
3. We must bring care and treatment within reach of all those infected. This
is not an alternative to prevention, but an essential complement to it,
since people will be more willing to take HIV tests when they know there
is hope of treatment.
4. We must protect those whom AIDS has left most vulnerable starting with
the orphans.
Prevention: Remedial Action
Though the disease was detected in High-risk group in developed countries, it is no
longer a menace. In developing countries, ignorance has helped spread the infection
at an alarming pace. Don't let anyone die of ignorance. HIV cannot be cured but can
be prevented. It's a classic situation where prevention by education has a Herculean
task to play.
Prevention is cheaper because it mainly involves changes in behavior to promote
abstinence, one sex partner, delaying the age of sexual relation, or safe sex with
condoms.
>
>
>
>
>
>
Sex Education in school Curricula.
Success of the Institution of Family.
Media's crucial role as an educating partner.
Political Commitment.
Society's active participation in checking the scourge.
Concerted efforts by Government agencies, Medical Profession, NGO's, , UN Agencies
and private sector.
Treatment of AIDS:
As of now, AIDS has become a manageable disease with drugs, which can be made
available at affordable prices [Generic form]
Over a long period of time, Anti retro viral drug should be initiated by a state- run
universal and free programme that provides HIV therapy. The 4-lakh people infected
in Karnataka [4 million Indians] now infected with HIV cannot be abandoned to a
wasting death when an affordable therapy is available.
Home health care for AIDS patient should be stressed.
World AIDS Conference declaration aptly summarizes - 'There is no end in sight to the
AIDS Pandemic. But, by working together we have the power to reverse its tide. Science will
one day triumph over AIDS, just as it did over Small pox. Curbing the spread of HIV will be
the first step. Until then, reason, solidarity, political will and courage must be our Partners'.
Dr. Sharad M.Tanga, MS; FICS
Garden Road,
Asst. Professor of Surgery,
R.I.District 3160,
Chairman, AIDS Awareness.
Gulbarga - 585 102.
Sharad_mt@vsnl.com
Encl: Pamphlets used by us.
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1. Use Condoms
2. Use of disposable syringes and needles
3. Avoid multiple partners
4. Use of HIV free blood
5. Proper treatment of sexually transmitted
diseases.
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6. Avoid injectable drug abuse
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AIDS does not spread by
j
1. Drinking water or eating food from the
same utensils used by the infected person
2. Sharing Toilet
3. Shaking hands
4. Hugging
5. Donating olood
6. Working with people who are HIV infected
7. Swimming in pools used by the people
with HIV/AIDS (cuts and sores over the
body should be covered with plaster)
8. Socializing or casually living with people
with HIV/AIDS (HIV infected individuals
need more care and support)
9. Through Mosquito bite
Dr. Sharad M. Tanga
- carol! ddd <ao. Sons
R.l. Distnct 3160
Chairman, AIDS Awareness
Plesse read and display Programme organized by: Rotary Club of
it scmewhe
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President
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KARNATAKA
Karnataka
1 Name and Address
Society for People’s Action for Development (SPAD)
Flat No. 1-13 Orient Manor, 15 High Street
Cooke Town, Frazer Town Post
Bangalore - 560 005
Name and Address
cf the Chief
Functionary
Augustine C Kaunds (President)
Society for People’s Action for Development (SPAD)
Flat No. 1-13, Orient Manor, 15, High Street
Cooke Town, Frazer Town Post
Bangalore - 560 005
3
Tjpe of Project Lirtertakeri
Targeted Intervention
4
Target Group Covered
Commercial Sex Workers
5
Area of Cperaticn
(District Fferre)
Kalasipalyam, Chamarajpet, Mysore Road
6
Year of TrriHeHm
1999
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
Rs.
-
-
30500C
2
Samuha Samraksha
No. 71/1, Harris Road, Benson Town,
Behind ISI Bangalore -560 046
Sangamitra Lyenagar
Director
No. 71/1, Harris Road, Benson Town
Behind ISI Bangalore -560 046
Tnl ■ 223R397 Fax -■ 2993710-F mail’-fimrakfih@yahQO.Gom___
Targeted intervention
Bangalore (Majestic, K.R. Market, Shivaji Nagar, Chamarajpet)
2000
19992000
20012002
Current
Year
(20022003)
Rs.
Rs.
300000
101760 )
20002001
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
1098130
-
-
533012
228200
302591
-
N CO
19992000
20002001
20012002
Current
Year
(20022003)
179
cm k-F
•cm k +
1
Freedom Foundation
No. 180 Hennur Cross
Bangalore- 560043
Name and Address
Jadar Gali, Shanthinagar
Bijapur- 586104
2
Name and Address
of the Chief
Functionary
Sunandana V. Tolabandi
Programme Co-ordinator
Ujwala Rural Development Services Society (URDSS)
Jadar Gali, Shanthinagar, Bijapur - 586104
Ashok K Rao
Executive Trustee
Freedom Foundation
No. 180 Hennur Cross
Bangalore- 560043
3
Type of Project lirfertaken
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Commercial Sex Workers
Commercial Sex Workers
Siraguppa, Sindhanur)
(District Iferoe)
2001
Year cf TrriHaHm
2001
7 Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
19992000
Rs.
Rs.
Rs.
-
-
6
N
20002001
Year
(20022003)
2002
19971998
19981999
19992000
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
512100
423000
-
-
-
CO
Current
Year
(20022003)
20002001
20012002
Rs.
Rs.
Rs.
90658
1411500
-
18 0
cm k +
1
Name and Address
Jagruthi
Jyothi Complex C-3
llnd Floor No. 134/1
Infantary Road, Bangalore - 560 001
Bhoruka Charitable Trust
Transport House
No. 57/58, 2nd Cross, Kalasipalyam, New Extention
Bangalore 560 002
2
Name and Address
of the Chief
Functionary
Renu Appachu
Director
Jagruthi, Jyothi Complex, C3, II Floor
No. 134/1 Infantry Road, Bangalore - 560 001
Tel. : 080-2860346
Dr. Surya Prakash
Program Manager
Bhoruka Charitable Trust, Transport House
No. 57/58, 2nd Cross, Kalasipalyam, New Extention
Bangalore 560 002
3
Tjpe cf Prcrject UxErtsken
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Men Who Have Sex with Men
Truck Drivers
5
Area of Operation
(District ifeme)
Bangalore
Bangalore (NH4, Tumkur Raod, APMC Yard and
Devraj URs Truck Terminal)
6
Year cf "rriHaHm
1999
2001
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
19992000
20002001
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
150000
150000
605800
N CO
20012002
Current
Year
(20022003)
19971998
19981999
Rs.
Rs.
Rs.
405250
-
-
19992000
Current
Year
(20022003)
20002001
20012002
Rs.
Rs.
Rs.
Rs.
-
-
1286588
-
18 1
cm k +
J
1 Name and Address
Truck Workers Welfare & Charitable Trust (TWCT)
No. 2, 1st Cross, Chickkanna Garden
Shankarapuram, Bangalore-560 018
Citizen's Alliance for Rural Development and Training Society
(CARDTS), D. No. 10-150, D’souza Villa, Behind Sheetal
Apartment, Near Mahakah Temple, Ujjodi Post, Kankandy,
Mangalore-0575002
2
Name and Address
of the Chief
Functionary
D. Channa Reddy
Managing Trustee
Truck Workers Welfare & Charitable Trust (TWCT)
No 2, 1st Cross, Chickkanna Garden
Shankarapuram, Bangalore-560 018
Bhagavandas M. (President)
Citizen’s Alliance for Rural Development and Training Society
(CARDTS), D. No. 10-150, Disouza Villa, Behind Sheetal
Apartment, Near Mahakah Temple, Ujjodi Post, Kankandy,
Mangalore-0575002
3
Type of Project Urfertaken
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Truck Drivers
Truck Drivers
5
Area of Operation
(District Ifeme)
Bangalore - Byattarahalli, Bommannahalli, Attibele
Tumkur- Kyapasandra to Nelamangala
6
Year c£ TrriHaHm
2002
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
-
-
569109
N
"1
L
4-
E
2002
19992000
20002001
20012002
Current
Year
(20022003)
CO
Current
Year
(20022003)
20002001
20012002
Rs.
Rs.
Rs.
Rs.
-
-
417150
-
19981999
19992000
Rs.
Rs.
-
-
19971998
182
k+
r
•in k-f-
1 Name and Address
Srikanth Education Society
Prema Nilaya, Near Stadium Devraj Urs Road
Vidya Nagar, Hassan - 573201
Tel. : 08172-69445 Fax : 50991
Bharuka Charitable Trust
Transport House, No. 57/58, 2nd Cross,
Kalasipalyam New Extension,
Bangalore-560 002
2
Name and Address
of the Chief
Functionary
Leela Sampige
Srikanth Education Society
Prema Nilaya, Near Stadium Devraj Urs Road
Vidya Nagar, Hassan - 573201
Tel. : 08172-69445 Fax : 50991
Dr. Surya Prakash, (Programme Manager)
Bhoruka Charitable Trust, Transport House
No. 57/58, 2nd Cross, Kalasipalyam New Extension,
Bangalore-560 002 Tel.: 2291738/2222311
Fax : 2224393 e-mail: bctbng@bgl.vsnl.net.in
3
Type of Project UrfertakEn
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Truck Drivers
Truck Drivers
5
Area of Cperatim
(District Name)
Hassan (NH 48)
Devanagunti off Hoskete
6
Year cf SriHaHm
1999
1999
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
767225
-
-
19992000
20002001
20012002
Current
Year
(20022003)
20002001
20012002
Current
Year
(20022003)
19971998
19981999
19992000
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
100000
400000
518500
878160
N CO
18 3
ni k +
1
Name and Address
Society for People's Action for Development (SPAD)
Flat No. 1-13 Orient Manor,
15 High Street Opp ITC Factory Gate
Cooke Town, Frazer Town, Bangalore- 560 005
Karnataka Integrated Development Services(KIDS)
Kalmath Building
Tikare Road, Dharwad 580001
2
Name and Address
of the Chief
Functionary ■
Augustine C. Kaunds (President)
Flat No. 1-13, Orient Manor, 15 High Street,
Cooke Town , Frazer Town, Bangalore- 560 005
Tel: 080-5461920 Fax: 5461920
E-mail: spadorg@satyam.netin
Pankaja Kalmath (Executive Director)
Karnataka Integrated Development Services (KIDS)
Kalmath Building, Tikare Road, Dharwad 580001
Tel.: 0836-740847/744196 Fax: 2120410/2120409
E-mail: kids-dharwad@hotmail.com
3
Type of Project Drrtertskm
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Truck Drivers
Truck Drivers
5
Area of Operation
(District Ifene)
Kalasipalyam, Chamarajpet, Mysore
Road and Battarahalli (NH-4)
Dharwad, Old Dharwad District, NH4 State, Highway, 290 km
and 130 km Tegur to Ranibennur, Khalgatgi to Gadag.
6
Year cf Trrit~iatim
2001
1999
7 Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
-
-
20012002
Rs.
Rs.
Rs.
-
-
1604000
Current
Year
(20022003)
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
650000
826150
872640
-
N CO
19992000
20012002
19971998
Current
Year
(20022003)
20002001
19992000
20002001
184
.m k +
m k4-
1
Name and Address
Bhoruka Charities
No. 48, Lavelle Road,
Bangalore 560001
Belgaum Integrated Rural Development Society (BIRDS)
Gokak Taluk, Belgaum District,
Karnataka - 591 319
2
Name and Address
of the Chief
Functionary
Krishana Madhav (Director)
Devendra Kattimani (Project Coordinator)
Bhoruka Charities, No. 48, Lavell Road,
Balgatore - 560 001
R. M. Patil
Executive Director
Belgaum Integrated Rural Development Society (BIRDS)
Gokak Taluk, Belgaum District,
Karnataka - 591 319
3
Type of Project lixtertaken
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Truck Drivers
Truck Drivers
5
Area of C^eratim
(District Nare)
Gulbaraa. Gum
Belaaum-NH4. 150 km. NH 4A53 km
6
Year cf Initiaticn
2001
2001
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
19992000
Rs.
Rs.
Rs.
-
-
20002001
20012002
Current
Year
(20022003)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
396900
248900
-
-
N CO
Current
Year
(20022003)
20002001
20012002
Rs.
Rs.
Rs.
Rs.
-
333900
1067580
-
19992000
185
m k+
an k4-
Citizen Alliance for Rural Development & Training Society
D.No. 10-150, D'souza Villa, Behind Sheetal Apartment,
Near Mahakali Temple, Ujjodi post, Kankanady,
Mangalore - 575 002 Tel. : 0824-431215 Fax : 437731
1
Name and Address
Suraksha
No. 76, 2nd Stage
Kamalanagar, Bangalore - 560 079
2
Name and Address
of the Chief
Functionary
Leela Sampige
Suraksha
No. 76, 2nd Stage
Kamalanagar, Bangalore - 560 079
3
Type o£ Project thtetakea
Targeted Intervention
4
Target Group Covered
Migrants
Targeted Intervention
5
Area of Operation
(District Jfeme)
Chandranagar, Part of Kasturba Government School Area
Migrants
6
Year cf Trrihiahioi
1999
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
200000
300000
609764
566819
Bhagavandas M (President)
Citizen Alliance for Rural Development & Training Society
D. No. 10-150, D'souza Villa, Behind Sheetal Apartment,
Near Mahakali Temple, Ujjodi post, Kankanady,
Mangalore - 575 002 Tel. : 0824-431215 Fax : 437731
Mangalore
19992000
20002001
20012002
Current
Year
(20022003)
m k+
2000
19971998
19981999
Rs.
Rs.
19992000
20002001
20012002
Current
Year
(20022003)
Rs.
Rs.
Rs.
Rs.
604000
520800
612854
1
Name and Address
Prajna Counseling Centre
Falnir Road
Kankanady, Mangalore - 575002
Grama Swaraj Samithi (GSS)
No. 139/7, Domulur Layout
Bangalore - 560 071
2
Name and Address
of tie Chief
Functionary
Prof. Hilda Rayappa (Director)
Prajna Counseling Centre
Falnir Road, Kankanady, Mangalore-575 002
Tel: 0824-432682
E-mail: prajnacc@bir.vsnl.net.in
Sudha Guru (Project Co-ordinator)
Grama Swaraj Samithi (GSS)
No. 139/7, Domulur Layout, Bangalore 560 071
Tel.: 5544245, 5351756, Fax : 5551086
E-mail: gss2000@satyam.net.in
3
Type cf Project Urhr.takai
Targeted Intervention
Targeted Intervention
4
Target Group Covered
Migrants
Migrants
5
Area of Operation
(District Name)
Mangalore
Upanagar, Kodigenahalti Panchayat, Yeshwanthpur Hobli,
Bangalore urban
6
Year cf TrHHaHm
2001
1999
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
240300
416600
N CO
19992000
20002001
20012002
E
20002001
Current
Year
(20022003)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
-
600000
380800
625615
Current
Year
(20022003)
+
19992000
20012002
18 7
1
Name and Address
Bangalore Oniyawara Seva Coota (BOSCO)
No. 91, B Street
6th Cross Gandhi Nagar
Bangalore 560 009
Asha Kiran Charitable Trust
Mahaveer Hospital, No. 119 D, 14/A Bamboo Bazar,
(Near Sunanda Agarbatti Factory)
New Sayyaji Rao Road, Mysore- 570021
2
Name and Address
of the Grief
Functionary
Fr. Varghese Koothungal (Executive Director)
No. 91, B Street
6th Cross Gandhi Nagar
Bangalore 560 009
Dr. S.N. Mothi (Chairman)
Mahaveer Hospital, No. 119 D, 14/A Bamboo Bazar,
New Sayyaji Rao Road, Mysore- 570021
Tel.: 0820-493985 Fax : 510688
E-mail: mayoral@vsnl.com, ashakirana@eth.net
3
Type of Project CfcxErtsken
Targeted Intervention
Care & Support (Community Care Centre)
4
Target Group Covered
Street Children
People Living with HIV/AIDS
5
Area of Operation.
(District Name)
Bangalore
Mysore
6
Year cf jnitiatim
1999
2001
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
19992000
20002001
Current
Year
(20022003)
20012002
19971998
19981999
19992000
20002001
20012002
Current
Year
(20022003)
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
359000
317000
723100
371565
-
-
-
779496
779496
-
N CO
18 8
•. m k +
k+
1
Name and Address
Freedom Foundation
No. 180 Hennur Cross
Bangalore 560043
Snehasadan
St. Camillus Rotary, Rehabilitation Centre,
P. O. Kinnikambla, Gurupur, Mangalore - 574151
2
Name and Address
of the Chief
Functionary
Ashok K Rau
Executive Trustee
Freedom Foundation
No. 180 Hennur Cross
Bangalore 560043
Fr. Joshy K (Director)
Snehasadan
St. Camillus Rotary
Rehabilitation Centre
PC. Kinnikambla, Gurupur, Mangalore - 574151
3
Type of Project lirtertakai
Care and Support (Community Care Centre)
Care and Support (Community Care Centre)
4
Target Group Covered
People Living with HtV/AIDS
People Living with HIV/AIDS
5
Area of Cperaticn
(District Narre)
Bangalore
Mangalore
6
Year Cf TrnHaHm
2001
2001
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
683550
1215000
19992000
20002001
19971998
19981999
Rs.
Rs.
Rs.
-
-
-
Current
Year
(20022003)
20012002
N CO
Current
Year
(20022003)
20002001
20012002
Rs.
Rs.
Rs.
Rs.
-
779496
1386996
-
19992000
18 9
<m k +
1
Name and Address
Snehadaan
St. Camillus Home of Charity
Sarjapura Road, Ambedkar Nagar, Carmelaram Post
Bangalore - 560 035
Freedom Foundation
No. 180, Hennur Cross,
Bangalore-560043
2
Name and Address
of the Chief
Functionary
Fr. Baby lllickal (Procurator/Administrator)
Snehadaan, St Camillus Home of Charity
Sarjapura Road, Ambedkar Nagar,
Carmelaram Post
Bangalore - 560 035
Ashok K. Rau
Executive Trustee
Freedom Foundation
No. 180, Hennur Cross,
Bangalore-560043
3
Tyre of Project Lirfertaken
Care and Support (Community Care Centre)
Care and Support (Community Care Centre)
4
Target Group Covered
People Living with HIV/AIDS
People Living with HIV/AIDS
5
Area of Cperaticn
(District Uferne)
Bangalore
Bellary
6
Year cf lYrit-iaHm
2001
2001
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
19992000
20002001
Current
Year
(20022003)
20012002
19971998
19981999
19992000
20002001
20012002
Current
Year
(20022003)
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
1508496
559209
602567
-
-
-
760000
1215000
1215000
• m k+
1
Name and Address
Freedom Foundation
No. 180. Hennur Cross,
Bangalore-560043
Karnataka Network for People Living with HIV/AIDS
No. 113, 1st Floor, 8th Main, 15th Cross, Wilson Garden
Bangalore - 560 030
2
Name and Address
of the Chief
Functionary
Ashok K. Rau
Executive Trustee
Freedom Foundation
No. 180. Hennur Cross
Bangalore-560043
Elango (Project Co-ordinator)
Karnataka Network for People Living with HIV/AIDS
No. 113, 1st Floor, 8th Main, 15th Cross, Wilson Garden
Bangalore - 560 030 Tel.: 080-2120409 Fax: 2120410
E-mail: knpplus@vsnl.net.in
3
Type of Project lixtertakm
Care and Support (Community Care Centre)
People Living with HIV/AIDS
4
Target Group Covered
People Living with HIV/AIDS
People Living with HIV/AIDS
5
Area of Cperatim
(District Jferre)
Udupi
Bangalore
6
Year cf TrriHarim
2002
2000
7
Amount Sanctioned to
the NGO
(in Rupees)
19971998
19981999
19992000
20002001
20012002
Current
Year
(20022003)
19971998
19981999
19992000
Network & Drop-in Centre
20002001
20012002
Current
Year
(20022003)
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
-
-
-
1948740
-
-
300000
355000
460000
-
N CO
191
. ni k +
cm k 4 -
in k +
1
Name and Address
Asha Foundation
No. 58, SBM Colony
3rd Main Anand Nagar
Bangalore - 560 024
2
Name and Address
cf the Chief
Functionary
Dr. Glory Alexandar
Chairperson
Asha Foundation
No. 58, SBM Colony, 3rd Main Building, Anand Naga
Bangalore 560 024
3
Type cf Project llxfertakm
Tele-counseling
4
Target Group Covered
General Public
5
Area of Operation
(District Name)
Bangalore
1999
7 Amount Sanctioned to
the NGO
(in Rupees)
19971998
20002001
20012002
Current
Year
(20022003)
19981999
19992000
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
-
-
55000
386341
333000
-
192
r
Position: 749 (6 views)