National AIDS Control Programme

The government launched the National AIDS Control Programme (NACP) in 1992. The NACP is a comprehensive programme for controlling and preventing HIV/AIDS in India. With time, the focus shifted from increasing awareness to behaviour change and from a national response to a decentralised response. It also focused on increasing the involvement of NGOs and networks of individuals living with HIV (PLHIV).

Phases of NACP

The government implemented the NACP in phases. The NACP I was started in 1992 with an objective to slow down the spread of HIV infections to reduce mortality, morbidity and the impact of AIDS in India.

In November 1999, NACP II was launched to reduce the spread of HIV infection and increase India’s capacity to respond to AIDS/HIV on a long-term basis.

In July 2007, NACP III was launched with the objective of reversing and halting the epidemic over five years.

NACP IV was launched in 2012 with an aim to speed up the process of reversal and strengthen the epidemic response through a well defined and cautious integration process over the next five years in India.

Strategies of NACP

• Consolidate and intensify prevention services, focusing on vulnerable populations and High-Risk Groups (HRGs).
• Increase access and promote comprehensive support, care and treatment.
• Expand IEC services for the general population and HRGs focusing on demand generation and behaviour change.
• Build capacities at district, state, national and facility levels.
• Strengthen strategic information management system.

Priorities Under NACP IV

• Prevent new infections through effectively addressing emerging epidemics and sustaining the reach of current interventions. 
• Prevent parent to child transmissions.
• Focus on awareness amongst the general population, IEC strategies for behaviour change in HRGs and demand generation for HIV services.
• Provide comprehensive support, care and treatment to eligible PLHIV.
• Reduce discrimination and stigma through greater involvement of the PLHA (GIPA).
• Decentralise rollout of services, including technical support.
• Ensure effective usage of strategic information at every level of the programme.
• Build capacities of NGOs and civil society partners, especially in the states with emerging epidemics.
• Integrate HIV services with health systems in a phased manner.
• Mainstream HIV or AIDS activities with all key state and central level ministries or departments.
• Strengthen social protection and insurance mechanisms for PLHIV. 

Services Provided under NACP IV

The services provided under NACP IV are as follows:

Prevention Services

• Targeted interventions for HRGs and bridge population [Female Sex Workers (FSW), Transgenders/Hijras, Men who have Sex with Men (MSM), Injecting Drug Users (IDU), migrants and truckers].
• Opioid Substitution Therapy (OST) and Needle-Syringe Exchange Programme (NSEP) for IDUs.
• Prevention interventions for the migrant population at destination, source and transit.
• Link Worker Scheme (LWS) for vulnerable populations and HRGs in rural areas.
• Prevention and control of Sexually Transmitted Infections/Reproductive Tract Infections (STI/RTI).
• Blood safety.
• HIV counselling and testing services.
• Prevention of parent to child transmissions.
• Condom promotion.
• Information, Education and Communication (IEC) and Behaviour Change Communication (BCC).
• Social mobilisation, adolescent education programme and youth interventions.
• Mainstream HIV/AIDS response.
• Workplace interventions.

Care, Support and Treatment Services

• Free first and second-line Antiretroviral Treatment (ART) through ART centres, Linking ART Centres (LACs), ART plus centres and Centres of Excellence (COE).
• Laboratory services for CD4 testing and other investigations.
• Paediatric ART for children.
• Early infant diagnosis for HIV exposed children and infants below 18 months.
• HIV-TB co-ordination (detection, cross- referral, and treatment of co-infections).
• Treatment of opportunistic infections.
• Drop-in centres for PLHIV networks.

Initiatives Under NACP IV

• Differential strategies for districts based on the data triangulation with weightage to vulnerabilities.
• Scale-up of Opioid Substitution Therapy (OST) for IDUs.
• Scale-up of programmes to target key vulnerabilities.
• Scale-up and strengthen migrant interventions at transit, source and destinations, including the rollout of a migrant tracking system for effective outreach.
• Establish and scale-up Transgenders (TGs) interventions through community participation and focused strategies for addressing their vulnerabilities.
• Employer-led model to address vulnerabilities amongst migrant labour. 
• Female condom programme.
• Scale-up multi-drug regimen for Prevention of Parent to Child Transmission (PPTCT) in line with international protocols.
• Social protection for marginalised populations by embarking and mainstreaming budgets for HIV amongst the concerned government departments.
• Establish metro blood banks and plasma fractionation centres.
• Launch of third-line ART and scale up first and second-line ART.
• Demand promotion strategies, especially using mid-media, such as National Folk Media Campaign and Red Ribbon Express and buses in convergence with the National Health Mission.