National AIDS Control Programme

SIKKIM AIDS CONTROL PROGRAMME

BACKGROUND:

NACP IV will integrate with other national programmes and align with overall 12th Five Year Plan goals of inclusive growth and development. Having initiated the process of reversal in several high prevalent areas with continued emphasis on prevention, the next phase of NACP will focus on accelerating the reversal process and ensure integration of the programme response.

The main objective of NACP IV is to:

i. Reduce new infections by 50 percent (2007 Baseline of NACP III).

ii. Provide comprehensive care and support to all persons living with HIV/AIDS and treatment services for all those who require it.

This will be achieved through the following strategies:-

i. Intensifying and consolidating prevention services with a focus on (a) high-risk groups and vulnerable population and (b) general population.

ii. Expanding Information, Education and Communication (IEC) services for (a) general population and (b) High-Risk Groups (HRGS) with a focus on behaviour change and demand generation.

iii. Increasing access and promoting comprehensive Care, Support and Treatment (CST)

iv. Building capacities at National, State, District and facility levels

v. Strengthening Strategic Information Management Systems.

  1. Year wise detection of HIV Cases as of 31/03/2016
YearMaleFemaleSurveillanceTotal 
MaleFemale
1995
2
0
0
0
2
1996
0
0
0
0
0
1997
1
0
0
0
1
1998
3
1
0
0
4
1999
5
0
0
0
5
2000
1
0
0
0
1
2001
2
0
0
4
6
2002
3
1
0
1
5
2003
3
1
0
1
5
2004
5
0
0
0
5
2005
9
2
2
1
14
2006
9
4
1
1
15
2007
12
7
0
0
19
2008
26
15
2
1
44
2009
16
13
4
6
39
2010
24
11
0
0
35
2011
19
15
0
0
34
2012
22
23
0
0
45
2013
10
8
0
0
18
2014
18
16
0
0
34
2015
18
16
0
0
34
2016
3
4
0
0
7
Total
211
137
9
15
372

(B) Age wise breakup of HIV Cases.

YearMaleFemaleSurveillanceTotal 
MaleFemale
1995
2
0
0
0
2
1996
0
0
0
0
0
1997
1
0
0
0
1
1998
3
1
0
0
4
1999
5
0
0
0
5
2000
1
0
0
0
1
2001
2
0
0
4
6
2002
3
1
0
1
5
2003
3
1
0
1
5
2004
5
0
0
0
5
2005
9
2
2
1
14
2006
9
4
1
1
15
2007
12
7
0
0
19
2008
26
15
2
1
44
2009
16
13
4
6
39
2010
24
11
0
0
35
2011
19
15
0
0
34
2012
22
23
0
0
45
2013
10
8
0
0
18
2014
18
16
0
0
34
2015
18
16
0
0
34
2016
3
4
0
0
7
Total
211
137
9
15
372

(C) Modes of transmission of HIV Cases

SexualIVDUBlood TransfusionParent to ChildOthers     
Male
Female
Male
Female
Male
Female
Male
Female
Male
Female
182
132
21
1
3
3
6
9
9
6
3142261515
372

(D) District Wise HIV Distribution

DistrictMaleFemaleTotal
East12797224
West191231
North314
South281846
Others462167
Total223149372

(E) Modes of transmission of HIV/AIDS Cases detected during HSS

YEARSTDANCIDUFSWTOTAL
200113004
200201001
200301001
200400000
200511103
200601102
200700000
20080123
2009414110
201000000
TOTAL698124

(F) TOTAL CASES REGISTERED AT ART CENTRE.

STATUSMALEFEMALETOTAL
PRE ART81523
ART7564139
TRANSFERRED OUT552580
LOST TO FOLLOW UP459
DEAD543387
Opted Out5611
TOTAL201148349
  • Number of cases registered through HSS is: 14 male + 9 female = 24
  • Cases not registered at ART centre due to non availability of proper registration system before 2005= 34

(G) AGE WISE BREAK UP OF Total CASES REGISTERED AT ART CENTRE

Sl. No.AGEMALEFEMALETOTAL
1.< 107815
2.11-19303
3.20-295258110
4.30-398658144
5.40-49371855
6.50-5912315
7.>60437
Total201148349

(H) TRANSFERRED IN AIDS CASES

MALEFEMALETOTAL
11819

(I) TOTAL AIDS CASES

MALEFEMALETOTAL
472875

B. PROGRAMMES/ACTIVITIES OF SIKKIM STATE AIDS CONTROL SOCIETY

1). Blood Safety

In Sikkim there are three Blood Banks which as follows:

a). STNM Hospital, Gangtok

b). Central Referral Hospital(not supported by NACO)

c). District Hospital Namchi.

District hospitals of Gyalshing,Singtam and Mangan have one blood storage centres. All Blood Banks are regularly inspected by experts for strict compliance of quality assurance. Every blood unit is tested for HIV, Hepatitis B, C, Syphilis and malaria Till date there is no transfusion related HIV infection reported from Sikkim.

Status of Physical target:

Sl. No.ActivitiesTargetAchievement
Till March 2016
Proposed Target 2016-17
1.
Total Blood Collection
4500
6317
6000
2.
Total Voluntary Blood Collection
4050
4270
5400
3.
Total % of VBD
90%
68%
90%
4.
Total Blood Collection in NACO supported Blood Banks
3150
4287
4500
5.
Total Voluntary collection in NACO supported Blood Banks
2835
2976
4050
6.
Total % of VBD in NACO supported Blood Banks
90%
69%
90%
7.
Total VBD Camps
34
42
40
8.
Collection in VBD Camps
1418
2207
2200

2). Sexually Transmitted Diseases (STD)

In Sikkim we have 6 STD Clinics located in each of the Govt. District Hospitals, STNM Hospital Gangtok and one at Sikkim Manipal Institute of Medical Sciences. Services of trained doctors and counsellors are available in these clinics.

These clinics cater to the need of general population, antenatal mothers and High Risk groups as well. The STI/RTI services to the HRGs (FSW & IDUs) and Bridge population (migrants) are being delivered through TI programmes. STI/RTI service delivery is one of the vital components of NACP-IV which is being implemented in collaboration with RCH programme of NRHM. Counsellors has been placed in all the 6 Designated STD Clinics. The infrastructure has been provided by the concerned institutions/hospitals. The STI/RTI drugs and consumables are supplied through SSACS.

Status of Physical Target:

Physical targets and achievement for the financial year 2015 – 2016

 

TOTAL TARGET 3554

    
DSRCTI NGOTOTAL


1


Clinical visit with STI/RTI complaint and were diagnosed with an STI/RTI

FEMALE
1267
110
1377
MALE
279
36
315
TOTAL1551
146
1697


2


Clinical visit with STI/RTI complaint and were NOT diagnosed with an STI/RTI

FEMALE
80
2324
2404
MALE
80
2413
2493
TOTAL160
4737
4897


3


Total episodes treated

FEMALE
1288
133
1421
MALE
323
35
358
TOTAL1611
168
1779

3). ICTC (Integrated Counselling & Testing Centres)

Sikkim has 13 ICTCs, two each at District Hospitals, CRH and at SACS Office, STNM Hospital Complex, Gangtok and one at Jorethang PHC. Each centre has one counsellor and one laboratory technician. Centres function from morning till afternoon and each centre receives an average of 10 clients a day. Many HIV cases were picked up at these centres.

One mobile ICTC consisting of a counsellor and lab. Technician covers the areas not covered by the Stand Alone ICTCs. The mobile ICTC goes to the State Jail, SAP, SSB, ITBP, Police Training Centre, Yangang, distant PHCs, etc

Facility Integrated ICTC is established at 14 24X7 PHCs across the state. Screening of HIV is done in these centres through single test and in case the samples are sero reactive the confirmatory tests are done using second and third test at Stand Alone ICTC.

Target and Achievement for General Client

Year 2015-16Target for 2016-17
Target for General client testing
20000
20000
No. Tested for HIV (with % )
17868(89.34)
-
No. Found HIV +ve (with %)
27(0.15)
-

Target and Achievement forANC Client

Year 2015-16Target for 2016-17
Target for ANC HIV Testing
12000
12000
No. Tested for HIV (with % )
7818(65)
No. Found HIV +ve (with %)
4(0.05)

4. TIs (Targeted Interventions)

Targeted Intervention Programmes:

Targeted Intervention Programmes are aimed at offering Prevention and Care services to high risk populations (Female Sex Workers- FSW, Male Having Sex with Male- MSM and Injecting Drug Users- IDUs) within communities by providing them with the information, means and skills they need to minimize HIV transmission and improving their access to care, support and treatment services.

It is estimated that more than 90% of HIV transmission in India is related to unprotected sexual intercourse or sharing of Injecting equipment between an infected and an uninfected individuals. Not everyone in the population has the same risk of acquiring or transmitting HIV. Much of the HIV transmission in India occurs within groups of network of individuals who have higher levels of risk due to a higher number of sexual partners or the sharing of injecting equipment.

These programmes also improve Sexual and Reproductive Health (SRH), among these populations and improve general health by helping them reduce the harm associated with behaviour, such as, sex work and Injecting drug use.

Sikkim State AIDS Control Society has been implementing Targeted Intervention (TI) Projects from the year 2000 onwards. At present there are 7 nos. of Targeted Intervention Programmes in the State implemented by the local NGOs among the core groups like Intravenous Drug Users (IDUs) and Female Sex Worker (FSW) population.

The Implementing Organization, target group and the area of operation is as follows:

Sl. No.
Name of Implementing Organization
Target Group
Area of Implementation
1.
Voluntary Health Association of Sikkim - I
FSWs
Gangtok.
2.
Voluntary Health Association of Sikkim - II
FSWs
Singtam
3.
Hope Foundation - I
IDUs
Jorethang.
4.
Hope Foundation - II
IDUs
Namchi.
5.
Sikkim Rehabilitation & Detoxification Society- I
IDUs
Gangtok & Ranipool
6.
Sikkim Rehabilitation & Detoxification Society- II
IDUs
Singtam & Rangpo.
7.
Drishti
FSWs
Namchi & Jorethang

Besides that there are 3 nos. of Opioid Substitution Therapy (OST) Centres under public health set up located in the Psychiatry Deptt. STNM Hospital, Gangtok, District Hospital, Singtam and District Hospital, Namchi in the East and South Districts respectively. The above centres are providing services to the opioid dependant clients.

5.ART Centre

Anti Retroviral treatment centre is located in the ground floor of SACS Office, STNM Hospital, Gangtok started in October, 2005. Here patients coming / referred from different places are registered and followed up with clinical assessment and CD4 counting. When they are entering danger level of AIDS symptoms based upon clinical signs and symptoms and CD4 count they are put on ART, which is given free of cost.

At present ARV drugs are being supplied directly by NACO.

Target and Achievement

2015-2016 2016-2017

S. No.Indicator Status as on 31.03.2015 (cumulative since begining)Cumulative targetCumulative achievement (current)New ProposalsCumulative target
1 ART Plus Centres 11 1 0 1
2 Link ART Centres 1 0 1 0 1
3 Care & Support Centres 1 0 1 0 1
4
CD4 testing facility 1
0
1
0
1
5 PLHIV registered in HIV care (Pre ART) 294 334 370 370
6 PLHIV currently alive & on first line ART 110 164 126 160 164
7 PLHIV currently alive & on second line ART1 247
8 CLHIV registered in HIV care (Pre ART)15 182016
9 CLHIV currently alive & on ART6 91514
10 Pregnant women initiated on ART/ARV Prophylaxis Annualy18 1595%
11 HIV- TB Co-infected patients initiated on ART4395 % of the total detected627595%
12 Total PLHIV who are on ART Linked out to LAC910101590%

6).IEC Programme Report

During the year 2015-2016 an array of IEC activities were conducted to create awareness on HIV/AIDS, Substance Abuse, Adolescent Education, Life Skills and other related issues. The issues were addressed through various mediums such as Radio, Private FM Stations, Local cable network, newspapers, trainings, awareness programmes, hoardings, information panels, Folk media campaign etc.

Brief reports of the programmes are as follows:

  1. Theme based audio video spots were released on Special events as National Voluntary Blood Donation Day, World Blood Donors Day, International Day against Drug abuse and Illicit trafficking and World AIDS Day (the above mentioned days are categorised as Special Event by the National AIDS Control Organization, NACO). These were telecast through local cable Nayuma Entertainment Television.
  2. Theme based audio spots were also broadcast through Private FM Stations on Special Events.
  3. To create awareness among rural population, Folk Media Campaign was conducted in all the four districts. The main objective of the Campaign is to generate awareness through infotainment. The various topics covered were Basics of HIV, effects of Substance abuse and alcohol, Voluntary Blood Donation, Advantages of institutional delivery, Youth and HIV, Information on referral services and Behavioural Changes.

The Campaign was implemented by Dasharthick Sangh, Gelling in West Sikkim, Voluntary Health Association of Sikkim in South Sikkim, Sikkim Lepcha Youth Association in North Sikkim and Arithang Mahila Kalyankari Sangh and Khusboo and Group in East Sikkim. A total of 360 performances were accomplished during the process.

  1. Similarly the adolescent issues were addressed through Adolescent Education Programme. The programme were conducted in 40 Junior High School, Secondary Schools and Senior Secondary Schools of East District. The main objective of the programme was to impart education and knowledge on the various physical, biological, behavioural, and emotional changes of an adolescent.
  2. ASHAs and AWWs play a vital role in reaching the rural mass and are one of the major resource supports at the field level. Hence they were trained and educated on the basics of HIV.
  3. Similarly Police personnel recruited under Indian Reserve Battalion (IRB) based in Peepalay, Jorethang, Yangyang Police Training Centre and SAP Pangthang were also sensitized on the effects of HIV and other related issues.
  4. Some of the Special Events were conducted in a grand manner such as Voluntary Blood Donation Day, International Day against drug abuse and illicit trafficking and World AIDS Day were commemorated. These events were organized in collaboration with Voluntary Blood Donation Association of Sikkim, Red Ribbon Clubs, Mental Health, Faith Based Organizations, Stakeholders, Schools and Colleges, local NGOs, TI partners, District Hospitals and Press and Media.
  5. The members of Nehru Yuva Kendra Youth were also sensitized on Youth and HIV, effects of Substance Abuse and alcohol, Life Skills and adolescent issues.
  6. Residential training of Red Ribbon Club members were also conducted in South and West District. During the training various issues as adolescent problems, teenage pregnancies, voluntary blood donation, mental health, youth and HIV, life skills etc were addressed by different resource persons.
  7. The members of Faith based organizations also play an important role in generating awareness amongst the fellow religions. To further enhance the education on HIV, the members of Faith Based Organizations were also sensitized.
  8. Press and Media is one of the influential forum through which a majority of issues can be addressed. Hence advertisements were also released in local newspapers (daily and weekly) during World AIDS Day to educate and inform the general population.
  9. The IEC activities were also implemented by various local NGOs in all the districts.

7). Montoring and Evaluation:

Reports on all these activities are to be forwarded every month on- line (SIMS) from all reporting units to SSACS office where it is analyzed, compiled and forwarded to NACO, New Delhi who keeps, compiles and compares among the states in the country.