HIV/AIDS in India and UNICEF in Action

The National AIDS Control Programme (NACP) III 2007-2012 has the overall goal of halting and reversing the epidemic in India. Over 99 per cent of the population in the country is free from infection. NACP III places highest priority on prevention while seeking to integrate care, support and treatment for those affected by HIV/ AIDS. 

Fast Facts

Global, Regional & India Estimates

• An estimated 33.4 million people worldwide were living with HIV (2008).
• Approximately 2.1 million children under 15 were living with HIV (2007).
• An estimated 2.1 million people died of AIDS-related causes (2007).
• An estimated 290,000 children under 15 died of AIDS-related causes (2007)
• India has a low HIV prevalence of 0.34 per cent. Yet in terms of individuals infected, India is home to the third largest number of people living with HIV in the world.
• The vast majority of HIV infections in India occur through sexual transmission (85.6 per cent).
• Nearly five per cent of infections are attributable to parent-to-child transmission.
• The epidemic disproportionately affects women, who account for 40 per cent of the total infections in the country.
• In India, the epidemic is more pronounced in urban areas than rural ones and decreases with increasing education levels.

Key Issues

The Four Ps:
The global and country level response to HIV is based on a comprehensive approach that includes the following four strategic elements, or the four P’s:

• Preventing HIV transmission from women living with HIV to their infants.
• Primary prevention of HIV infection among couples of child bearing age.
• Preventing unintended pregnancies among women living with HIV.
• Providing appropriate protection to children affected by HIV and their families.

Prevention of parent-to-child transmission (PPTCT)

• In India, the transmission of the virus from the mother-to-child during pregnancy, labour and delivery or breastfeeding is called parent-to-child-transmission to emphasize the role of the father in both the transmission of the virus and management of the infected mother and child.
• Nearly five per cent of infections are attributable to parent-to-child-transmission.
• It is estimated that out of 27 million pregnancies every year, nearly 49,000 occur in HIV-positive mothers.
• The number of facilities offering HIV testing and counseling went up from 4,269 in 2007 to 4,817 in 2008 and stands at 4,987 as of March 2009. As of December 2008, only 16 per cent of pregnant women were tested for HIV, while 22 per cent of the children born to the estimated 49,000 HIV-positive women were receiving anti retroviral prophylaxis.
• In 2009, only 11489 of an estimated 49,000 pregnant women living with HIV received anti-retroviral treatment to prevent parent-to-child transmission. This is because of multiple factors including social customs, lack of family support and financial barriers, which constrain women from availing of institutional care necessary for administering treatment.  PPTCT services have also not been scaled up in remote areas with lower HIV prevalence.
• One of the best practices in PPTCT in India is the outreach approach, used by the ICTC to ensure that HIV-positive women who are tested are followed up before, during and after an institutional delivery, and provided with anti-retroviral prophylaxis.
• The core principle of this approach rests on the continuum of care for women, children and their families – a chain of interventions that begin before pregnancy and continue through pregnancy, labour and delivery and subsequently as part of routine or specialized chronic care services for after the child is born.

Pediatric care and treatment:

• It is estimated that 70,000 children below the age of 15 are living with HIV in India and 21,000 children are infected every year through parent-to-child transmission. A small proportion are also infected by unsafe injections and infected by blood transfusions.
• Most children are infected with the virus while still in the womb, during birth or while breastfeeding.
• The National Pediatric Antiretroviral Treatment (ART) Initiative was launched in 2006. A total of 40,000 children living with HIV will be provided ART by the end of NACP-III.
• A total of 375 ART centres shall be equipped to offer pediatric ART in the country.
• Follow up of HIV exposed infants, according to the Indian Guidelines, begins at six weeks. The ‘Road to Health’ card for these children includes information on maternal HIV status, co-trimoxazole prophylaxis, infant HIV diagnosis and infant feeding information.
• To reach more mother-infant pairs, the Reproductive and Child Health (RCH) programme is linked to the PPTCT and Pediatric HIV programme in order to provide for and incorporate HIV care into the package of services for mothers and children.

Preventing infection among young adolescents and young people:

• In India, the prevalence of HIV among 15-19-year-olds is 0.04 per cent and that among 20-24 year olds is 0.18 per cent
• By the end of the NACP III, about 25 million students will have been reached through the Adolescent Education Programme
• The NACP III will also bring HIV prevention skills education programmes and related services to 70 million young people who are not in school, including, street children, children of CSWs, children in institutions, child labourers and other vulnerable youth.

Protection, care and support for children affected by AIDS:

• In the short term, NACP III will reach out to as many children living with HIV as possible to provide them with the treatment and the care and support services that they need. 
• In the long term, NACP III aims to ensure that every child has access to the same comprehensive set of basic health, education and social protection services, regardless of their HIV status or that of any member of their family.

UNICEF in Action

UNICEF supports the Government in its effort to halt & reverse the HIV/AIDS epidemic in India, and mitigate its impact on affected children and women.

UNICEF is assisting the government to further expand and enhance the quality of programmes to reduce the transmission of HIV from infected mothers to their children and to increase the access of these mothers and their children to treatment in various ways: by providing strategic supplies of drugs and commodities, improving the capacity of staff; by developing innovative communication approaches for prevention and care; helping to improve monitoring and reporting systems.

UNICEF supports efforts to reduce stigma and discrimination against children and people affected by HIV and for commitment on ensuring their equal access to essential health, social welfare and educational services.

UNICEF’s program contributes to increasing knowledge, dispelling myths and misconceptions relating to HIV transmission and prevention behaviors among vulnerable young people.

Source: UNICEF