As more than 99 percent of the population in the country is free from infection, TANSACS’ own strategies as well as phase III of the National AIDS Control Programme places the highest priority on efforts to prevent further spread of HIV/AIDS. TANSACS aims to achieve Zero incident of HIV infection in the state of Tamil Nadu. |
| Who is at risk? |
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The HIV prevalence trend in the state shows disproportionately higher incidence of the infection among certain population groups. An analysis of Annual Sentinel Surveillance data (2000-2007) shows that female sex workers (FSWs), men-who- have-sex-with-men (MSM) and injecting drug users (IDUs) have disproportionately higher prevalence of HIV infection (> 6% in MSM, > 3.5 in FSW).
Through MSM and sex worker-client interactions, the infection spreads to general population. As a majority of men with MSM behaviour are married and a majority of sex worker clients are migrant labours and truck drivers, they pose the risk of infecting their spouses and unborn children.
Specific strategies have been outlined to approach two major populations within the bridge population: truckers and high risk migrants.
Other Vulnerable Populations: Risk groups in rural areas, HIV-affected children, adolescents in the age group 15-19 and women receive a package of services delivered through a more extensive mechanism – that of the link workers.
To gain control over HIV/AIDS spread in the state, effective interventions have, therefore, been implemented for High Risk Groups (HRGs).
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| These core high risk groups (HRGs) of individuals who are most at risk include: |
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Female sex workers (FSWs) |
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High risk men who have sex with men (MSM), and transgenders (TGs) |
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Injecting drug users (IDUs) |
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| Note: HRGs refers only to core HRGs (FSWs, MSM/TGs, IDUs), and not to truckers/migrants. |
| Mapping and validation of core and vulnerable groups |
| It is estimated that in Tamil Nadu there are more than one lakh High Risk Groups who have to be covered (according to a study conducted by IMRB, with the support of APAC & TAI, in 2008) under a pro-active programme of targeted community-specific, need-based and comprehensively monitored interventions to reduce risk of infection. |
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Tamil Nadu has 102 Targeted Interventions programmes to halt and reverse the epidemic. The Targeted Intervention in Tamil Nadu is implemented through NGOs supported by TANSACS, APAC-VHS-USAID and TAI. |
| Districts allocation among partners |
The strength of the programme lies in common understanding among stake holders, and area demarcation to avoid duplication, evidence-based planning, a district-focused and decentralized approach and the ‘Three ones’ principle of reporting, leading to coordinated service delivery and utilization. |
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In Tamil Nadu, all the stake holders have completed a NGO-wise line listing of the HRGs with validation of the line listing , through which 72, 388 HRGs have been identified and registered for individual tracking and ensuring minimum package of services for the group. |
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| Intervention Package for HRGs covered under TI programme |
| Targeted interventions for HRGs offer a “package” of services |
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Outreach and Communication – peer-led and NGOs supported outreach and behaviour change communication
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Linkages to STI (sexually transmitted infection) services with a strong referral and follow up system
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Promotion/distribution of free condoms and other commodities (e.g. lubricants for MSM, needles/syringes for IDUs)
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Linkages to other health services (e.g. for TB) and voluntary counselling and testing centres (VCTC)
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Provision of safe spaces (drop-in-centres or DICs) |
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Creating an enabling environment including advocacy with key stakeholders/power structures, crisis management systems and Legal/Rights education |
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Community mobilisation for building community ownership of the TI’s objectives (“community” refers here to the HRGs: FSWs, high risk MSM and IDUs) and building capacity of community groups to assume ownership of the programme |
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| The methods adopted by TANSACS are |
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Hot spot based interventions. |
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Promoting positive prevention among PLHIV from core group. |
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Network with government and private agencies for non- programmatic services. |
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TANSACS ensures that all who need treatment have access to prophylaxis and management of opportunistic infections. People who need access to ART are assured first line ARV drugs |
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| Supervision and Monitoring |
The TI section carries out the administrative activities, while Technical Support Unit provides technical support and field level mentorship to the NGOs. STRC implements the training programmes with TANSACS.
TANSACS will continue to implement the Targeted Interventions (TIs) for High Risk Groups in the years to come, in order to ensure early intervention among FSW, MSM, IDU and Bridge population in mapped sites so that new infections among HRGs are prevented. TANSACS will continue to focus on capacity building, handholding and monitoring of NGOs /CBOs and encourage community participation to reach out to the hidden core population that need urgent intervention. |
