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India & Mizoram's response to the AIDS Epidemic.

Mizoram State AIDS Control Society

In Mizoram, the first case of HIV infection was seen in an injecting drug user during October. Initially HIV transmission in Mizoram was drug-driven, through sharing of infected syringes and needles. The 1990s saw the youth devastated by the twin epidemic of drug addiction and HIV/AIDS, many youth turining to herion which managesd to find its way from the Golden Triangle. A large number of youths also took to injecting an oral analgesic drug called proxyvon, with the resultant widespread toxic eddects like abscesses, amputation of limbs, tissue necrosis etc. Majority of HIV infection occured among the IDUs and their partners.

In 1992, the Government of Mizoram established the State AIDS Cell at the Directorate of Health Services headed by the Joint Director of Health Services in 1992-93. Mizoram State AIDS Conrol Society (MSACS) came into existence on the 22nd July 1998 under the Chairmanship of the Secretary, Health and Family WelfareThe State AIDS Policy was approved by the Council of Ministers on the 22nd October 1999.

Presently Governing Body of MSACS is chaired by the Hon’ble Health Minister with Secretary (Health) as its Member Secretary. Executive Council is chaired by Health Secretary and Member Secretary is Project Director of MSACS.

Facilities/Programmes under Mizoram State AIDS Society

A. PREVENTION

I. Targetted Intervention (TI)
II. Link Worker Schemes (LWS)
III. Integrated Counseling and Testing Centre (ICTC)
IV. Sexually Transmitted Infections (STI) Clinics
V. Blood Safety
VI. Information, Communication and Education (IEC)

B. Care Support and Treatment (CST)

VII. ART Centres
VIII. Link ART Centres

C. Institutional Strengthening & Capacity building

IX. Administration – MSACS Office
X. DAPCU

D. Monitoring and Evaluation

XI. CMIS
XII. Sentinel Surveillance

National AIDS Control Organization

Introduction

In India the first case of HIV Infection was detected in 1986 among commercial workers in Chennai. Subsequently the Government of India initiated programmes of prevention and raising awareness under the Medium Term Plan (1990-92), the first National AIDS Control Plan (NACP-I, 1992-1999), second plan (NACP-II, 1999-2006) and the third (NACP-III, 2006-20012). NACP Phase-IV (2012)

India has the third largest HIV epidemic in the world. In 2017, HIV prevalence among adults (aged 15-49) was an estimated 0.2%. This figure is small compared to most other middle-income countries but because of India’s huge population (1.3 billion people) this equates to 2.1 million people living with HIV.

Overall, India’s HIV epidemic is slowing down. Between 2010 and 2017 new infections declined by 27% and AIDS-related deaths more than halved, falling by 56%. However, in 2017, new infections increased to 88,000 from 80,000 and AIDS-related deaths increased to 69,000 from 62,000. UNAIDS (2017) ‘UNAIDS data 2017’

In 2017, 79% of people living with HIV were aware of their status, of whom 56% were on antiretroviral treatment (ART). The proportion of people on ART who are virally suppressed is not reported.

The HIV epidemic in India is driven by sexual transmission, which accounted for 86% of new infections in 2017/2018.5 The three states with the highest HIV prevalence, Manipur, Mizoram and Nagaland are in the east of the country.

The epidemic is concentrated among key affected populations, however the vulnerabilities that drive the epidemic vary in different parts of the country. A key driver is unprotected sex among key populations and their clients, partners and spouses. However, injecting drug use in the north and northeast of the country is also pushing HIV prevalence up.6

Key population groups have been prioritised in the national AIDS response since its inception in 1992. Both the sex worker and men who have sex with men population groups have experienced a recent decline in HIV prevalence.

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