“Let Communities Lead”
The world can end AIDS, with communities leading the way. Organisations of communities living with, at risk of, or affected by HIV are the frontline of progress in the HIV response. Communities’ leadership roles need to be made core in all HIV plans and programmes and in their formulation, budgeting, implementation, monitoring and evaluation. “Nothing about us without us.”
As part of the HIV & AIDS Control programme happening globally, India works to combat AIDS, through National ACO under the Ministry of Health & Family welfare, Govt. of India. NACO envisions an India where every person living with HIV has access to quality care and is treated with dignity. Effective prevention, care and support for HIV/AIDS is possible in an environment where human rights are respected and where those infected or affected by HIV/AIDS live a life without stigma and discrimination.
National AIDS and STD Control Programme (NACP) now in the Phase-V is a Central Sector Scheme fully funded by the Government of India with an outlay of Rs 15471.94 crore. The NACP Phase-V will take the national AIDS and STD response till Financial Year 2025-26 towards the attainment of United Nations’ Sustainable Development Goals 3.3 of ending the HIV/AIDS epidemic as a public health threat by 2030 through a comprehensive package of prevention, detection and treatment services. The Phase-V builds upon the gamechanger initiatives of the HIV/AIDS Prevention and Control Act (2017), Test and Treat Policy, Universal Viral Load Testing, Mission Sampark, Community-Based Screening, transition to Dolutegravir-based Treatment Regimen etc and introduces newer strategies consolidating and augmenting the gains. This include setting-up of Sampoorna Suraksha Kendras (SSK) for providing services through a single window model for those “at risk” for HIV and STI covering prevention-test-treat-care continuum. It includes a holistic set of services customized as per clients’ needs, with strong linkages and referrals within and outside of health systems.
In Kerala the Kerala State AIDS Control Society (KSACS), plays a pivotal role in the state’s strategy in combating the HIV/AIDS epidemic. It is an autonomous society registered under the Charitable Societies Act, with its members drawn from all key government departments to ensure greater flexibility and more effective programme management.
The activities and service centers of KSACS are as follows:
HIV COUNSELLING & TESTING SERVICES (HCTS) - Integrated Counseling and Testing Centers (ICTC) Jyothis Centers
The Basic Services Division of Kerala State AIDS Control Society provides HIV Counseling and testing services (HCTS) for HIV infection, the critical first step in detecting and linking people with HIV to access treatment cascade and care.
The Basic Services Division through Integrated Counseling and Testing Centres (ICTCs) provide HIV counseling & testing services, Prevention of Parent to Child Transmission of HIV (PPTCT) services and HIV-TB cross referrals. These services have linkages with TI NGOs/CBOs and outward linkages with ART centres, outreach services, peer support services, Opportunistic Infection management and home based care. NACP-IV envisages integration and scale-up of service delivery to sub-district and community levels through existing infrastructure in the public and private sectors. There are 688 ICTCs are in Kerala including 2 Mobile ICTCs.
STI Clinics –Pulari Centres
Sexually Transmitted Infection/Reproductive Tract Infection (STI/RTI) Control Programme
Presence of a STI/RTI in the sexual partner increases the risk of acquisition of HIV from an infected partner by 8-10 folds. Effective control of STI/RTI is a strong and most cost effective strategy for reducing/preventing transmission of HIV. Standardized training to the medical and paramedical personnel based on syndromic case management approach is being provided and counseling services from trained counselors are made available at these clinics. Colour coded syndromic drug kits and RPR test kits are being centrally procured and supplied to these clinics. As of now, there are 23 STI Clinics (Pulari) spread across 14 districts in the state. These clinics are located in 9 district hospitals, 8 Govt. Medical Colleges, and 6 general hospitals. State Reference Laboratory at the Microbiology department, Medical College Trivandrum is also functioning.
The care, support and treatment need of HIV positive people vary with the stage of the infection. The HIV infected person remains asymptomatic for the initial few years; it manifests by six to eight years. As immunity falls over time the person becomes susceptible to various opportunistic infections (OIs). At this stage, medical treatment and psycho-social support is needed. Access to prompt diagnosis and treatment of OIs ensures that PLHIV. As live longer and have a better quality of life.
Care Support and Treatment services for People Living with HIV are provided through a network of ART centers. ART centers have been mostly established at medical colleges and district level hospitals to provide “Pre-ART” and ART services. A few ART centers have also been established at sub-district level in the high HIV prevalence states. Each ART centre has been further linked with a Centre of Excellence (CoE) and ART plus centre to ensure assessment and initiation of second line ART to the eligible patients. As ART centers are mandatory in medical colleges, new ART centers will be established in the current year. A proposal for establishment of Centre of Excellence at Trissur has already been forwarded.
Targeted Intervention (TI)-Suraksha Projects
Targeted Intervention (TI) is one of the main components under NACP IV. Kerala has rich experience in Targeted Intervention Program as the program started way back in 1996 and managed by different management units with the help of experienced technical professionals. The Program is designed to reduce the rate of HIV transmission among the Core Group viz. Female Sex Workers (FSWs), Men having Sex with Men (MSMs) and Injecting Drug Users (IDUs), Transgender & Bridge populations like Interstate Migrants and Long Distance Truckers. The TI programme was being implemented initially through Non-Governmental Organizations (NGOs)& Local Self Government (LSG), but an impact of the empowerment of the primary Stakeholder communities, lately, many of these projects have been entrusted for implementation through Community Based Organizations (CBOs). Some of these organizations have been implementing the project for more than 10 years. There are total 64 Suraksha Projects in Kerala. Kerala TI programme is branded as “SURAKSHA”. The Malayalam word Suraksha means “Safety”. The Suraksha programme is being implemented through the Community Based Organisations (CBO), Non-Governmental Organizations, and Local Self Governments (LSG).
Information, Education and Communication (IEC)
Information, Education and Communication (IEC) for promoting behaviour change and to encourage and sustain positive healthy behaviours among individuals and communities is the cornerstone of HIV programming. IEC embrace within its ambit not just material development but provide synthesis of Mass Media, IPC, Social mobilization and advocacy and community participation that all has to go hand in hand. Thus IEC is component specific, issue specific and catering to the needs of each and every target population perfectly blended with each and every component of National AIDS Control Programme. In the current phase of NACP, Information, Education and Communication activities focus on the areas of Mass Media, IEC printing and distribution, Outdoor and Mid Media, Events, Mainstreaming, Greater Involvement of People Living with HIV (GIPA) and Youth Affairs.
Information Communication Technology
Website: www.ksacs.kerala.gov.in.
Twitter: https://twitter.com/Kerala_SACS
Instagram: https://instagram.com/keralasacs
Youtube Channel: https://www.youtube.com/channel/UCsALk1whh0YELVz8ZQRtVjg
Helpline Number :1097
Red Ribbon Clubs
There are 315 Red Ribbon Clubs active in Professional & Art Colleges and ITIs all over Kerala
Annual programmes including competitions of Red Ribbon clubs colleges are being conducted by colleges.
Adolescent Health Education Programme (AHEP)
This programme that give awareness on the Process of Growing up emphasising HIV, STI, Drug Abuse, Voluntary Blood Donation, to High School and Higher Secondary School students through Nodal Teachers those who are trained Resource Persons is active in 5000 Schools across Kerala.
Out of School Youth Programme:
This focuses on youth who are not present in schools and colleges. To address this group activities are conducted with the support of Youth Welfare Board, Nehru Yuva Kendra, etc.
Advocacy & Mainstreaming Trainings:
Under this programme advocacy programmes with line departments and Stake holders are conducted and different types of Trainings like Orientation , Sensitisation and Induction trainings are conducted for staff and officials of various departments like Police, Education, Labour, Industries, Tribal Department, Railways, Women & Child, Etc.
Blood Transfusion Service (BTS) is a vital component in any Health Care Delivery System. Kerala gives highest priority for safe Blood Transfusion Service. As a result of the efficient and effective functioning of the Blood Safety Division of Kerala State AIDS Control Society and Kerala State Blood Transfusion Council, Blood Transfusion Service in Kerala has advanced significantly in the areas of donor selection & management, storage, grouping &cross matching of blood units collected, screening of collected blood for TTI (transfusion transmissible infections), rational use of blood etc.
At present 190 Blood Centers are functioning in Kerala including 42 Govt. Blood Centers. KSACS is giving priority for the upgradation of all Govt. Blood Centers as Blood Component Separation Units (BCSU) using plan fund. Steps have already been taken for achieving this goal.
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