Targetted Intervention
MIZORAM STATE AIDS CONTROL SOCIETY: TARGETED INTERVENTION DIVISION 2007 – 2018
High Risk Group
The key risk groups covered through TI Program include:
- Injecting Drug Users
- Female Sex Workers
- Men who have Sex with Men
- Migrants
Targeted Interventions are preventive interventions focused at High Risk Groups and Bridge populations in a defined geographic area. The TI Projects are peer-led interventions implemented through NGOs/Community Based Organizations (CBO). These projects are mentored, monitored and supported by State AIDS Control Societies. (SACS), Technical Support Unit (TSUs) and NACO. The NGOs/CBOs implementing the TI Projects collect field level data based on the reporting formats developed by NACO which form a part of national Monitoring and Evaluation framework.
Prevention strategies under TI focus on the following major components to reach the goal of halting and reversing the HIV epidemic among HRGs and Bridge population:
- Behavior Change Communication
- Treatment for sexually transmitted infections
- Distribution of condoms and other risk reduction materials.
- Ownership building
- Creating an enabling environment
- Needle syringe exchange program
- Opioid substitution Therapy.
Other Activities under TI
Social Model Network (SNM): In order for the transmission of HIV to decrease it is important to first find the hidden HIV+ve for which the Social Network Model (SNM) has been introduced in Aizawl district which has the highest IDU population as well as the highest number of HIV+ve.
This model aims to cover IDUs that have never registered at TI and have never received any HIV related services. The model has been able to reach out to 180 such IDUs within a span of 3 months. And we have seen the benefits of the Model and a replication of which is to other districts may result in similar outcomes.
- Positive Network Model (PNM): Positive Network Model Aims to reach out to IDUs from already HIV+ve client of the TI, who is not registered at the TI, but is in the network of the TI client and may or may not have become infected. PNM is rolled out in all Project Sunrise districts in Aizawl, Champhai and Kolasib. The model was rolled out in October 2017.
- Community Based Screening (CBS): Community Based Screening was rolled out in 17th October 2017 first in Aizawl based TI’s and eventually for all TIs and 3 LWS. With the introduction of CBS we have observed that HRGs who were unwilling to undergo HIV testing are not taking the test which shows that they are not reluctant to test but are reluctant to move out of their comfort zone to places like ICTC. CBS reaches HRGs in their comfort zone and is able to yield more results than during the time when HRGs had to go to ICTCs. However, a challenge remains in confirming the reactive cases to ICTC, for which best efforts are being made in close co-ordination with Basic Service Division.
- Mass Awareness: Due to the rapid growth of HIV transmission among both HRGs and general community, major awareness programs need to be conducted in various platforms. The church being a very influential entity in the state, Mizoram SACS is working closely with the biggest denomination, the Presbyterian Church Synod, and the Church has agreed to come up with a 5 year plan, the details of which is under process where MSACS is a member of the committee.
Apart from these, individual churches are requesting for HIV and drug awareness among young children and youth which has been repeated positively by MSACS with full support from Project Sunrise. Church advocacy and awareness is expected to increase as more requests are received.
Link Worker Scheme
Objectives of the Link Worker Scheme
1. The scheme aims at building a rural community model to address the complex needs of rural HIV prevention, care and support requirements in selected geographies.
2. The scheme aims at reaching out to rural population who are vulnerable and are at risk of HIV/AIDS in a non-stigmatized enabling environment.
3. The scheme aims at improving access to information materials, commodities (condoms, needles/syringes) through collaborating with nearest TI or government health facilities, testing and treatment services ensuring there is no duplication of services or resources.
4. The scheme aims at improving linkage to other social and health benefits provided by other line departments in line with local norms, regulations suitable for vulnerable populations.
Features of LWS
The features of this scheme are as follows:
1. The scheme uses evidence-based approach to identify rural areas having greater risk and vulnerabilities of contracting HIV through scientific tools such as broad mapping. Individuals/groups within the villages are identified for providing information and services based on detailed situation needs assessments.
2. The scheme envisages creation of demand for various HIV/AIDS related services and the linking of the target population to existing services. The scheme itself does not create any service delivery points.
3. The scheme involves highly motivated and trained community members – preferably a male or female cluster Link Worker for clusters of villages – who will establish linkages between the community on one hand and information, commodities and services on the other.
4. The scheme envisages creating an enabling and stigma free environment in the project area to ensure that the target population continues to access information, services in a sustained manner.
5. The scheme envisages creating linkages with services of other departments through ASHA volunteers, Anganwadi workers, Panchayat heads, MNREGA scheme officials etc. This is to ensure that the vulnerabilities are identified and addressed by building capacity of ground level stakeholders.
Services Provided under LWS
| Sl No. | Year | Target | Achievement | District | Name of Implementing NGO |
| 1 | 2009 | – | 1 | 1 Champhai | Champhai – MSD&RB |
| 2 | 2010 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 3 | 2011 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 4 | 2012 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 5 | 2013 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 6 | 2014 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 7 | 2015 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 8 | 2016 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 9 | 2017 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
| 10 | 2018 | 3 | 3 | 3 Aizawl, Champhai & Kolasib | Aizawl – FIWDC, Champhai MSD&RB, Kolasib SHADE |
Opioid Substitution Therapy
Opioid Substitution Therapy substitutes an illicit drug with a medically safe, long acting, legal medication. It is prescribed by a medical doctor and administered under the supervision of a trained nurse or pharmacist. The substituted drug is taken orally (sublingually) instead of injecting.
- Harm Reduction has multiple tiers of service delivery
- Along with NSEP, Oral substitution therapy (OST) is a well accepted strategy for HIV prevention, and forms the second tier of harm reduction
- OST is substitution of the drug user’s primary drug of use with a medically safer drug
- OST is substitution of primary route of use (injecting) with non-injecting route (Oral/ Sublingual)
List of OST Centers in Mizoram
| Sl. No | Name of Centre | District | Year of Roll out | Target |
| 1 | Society for Community Care | Aizawl | 2009 | 60 |
| 2 | Samaritan Society | Aizawl | 2010 | 100 |
| 3 | Mission for Social Reforms | Aizawl | 2009 | 100 |
| 4 | SHALOM | Aizawl | 2009 | 200 |
| 5 | Civil Hospital, Aizawl | Aizawl | 2014 | 100 |
| 6 | Lengpui PHC | Aizawl | 2014 | 100 |
| 7 | Darlawn PHC | Aizawl | 2014 | 100 |
| 8 | Civil Hospital, Champhai | Champhai | 2012 | 100 |
| 9 | Khawzawl CHC | Champhai | 2013 | 100 |
| 10 | District Hospital, Kolasib | Kolasib | 2012 | 100 |
| 11 | Vairengte CHC | Kolasib | 2013 | 100 |
| 12 | Civil Hospital, Lunglei | Lunglei | 2012 | 100 |
| 13 | District Hospital, Lawngtlai | Lawngtlai | 2013 | 100 |
| 14 | Civil Hospital, Siaha | Siaha | 2012 | 100 |
| 15 | District Hospital, Serchhip | Serchhip | 2013 | 100 |
| 16 | Thenzawl CHC | Serchhip | 2014 | 100 |
| 17 | District Hospital, Mamit | Mamit | 2013 | 100 |