Lok Sabha Question No. 1123 (UNSTARRED), answered on 2019-02-08
Subject: UNAIDS Report
Ministry: HEALTH AND FAMILY WELFARE
Asked by: MEENAKASHI LEKHI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1123 TO BE ANSWERED ON 08 TH FEBRUARY, 2019

## UNAIDS REPORT

## 1123. SHRIMATI MEENAKASHI LEKHI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether a report by UNAIDS states that only 79 per cent of people with HIV in India were aware of their condition and only 56 per cent of them has access to treatment, if so, the details thereof and thesteps ta ken by the Government to ensure that the early detection and treatments like viral load tests are made available to them;

(b) whether the Government is aware of the fact that tuberculosis has been one of the leading reasons for death of HIV patients and if so, whether the Government has formulated any scheme for the convergence  of  HIV  treatment  under  the existing  tuberculosis  programmes  and  if  so, the  details thereof;

(c)  whether  follow  up  procedures  are conducted  to  ensure  that  the  virus  load  tests are done  on patients; and

(d) if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a): Yes,Out of the total estimated 21.4 lakh people living with HIV (PLHIV ) (2017estimates) in India, 16.8 lakh (79%) are aware of their HIV status, and out of those who know their status, 11.9 lakh (56%) are on Anti Rota Virus Treatment (ART).

The steps taken by the Government to address early det ection and treatment is annexed.

- (b): Government is aware of the fact that tuberculosis has been one of the leading reasons for death of HIV patients.

The government has not formulated any scheme for convergence of the coverage of HIV treatment  under  the  existing  TB  programme because  as  per  the  recommendation  of  the  National Expert  group  on  TB - HIV,  provision  of  HIV  treatment  from  TB  treatment  centres  was  not recommended  as  PLHIV  are  26 - 31  times  higher  risk  of  developing  TB.However,  collaborative activities exist for treatment of TB- HIV co- infected patients which include, Single window service delivery  to  HIV  positive  individuals  through  provision  of  TB  services  at  (ART)  centres/ treatment  centreitself,  I ntensified  TB  Case  Finding  (ICF)  by  deployment  of  rapid  molecular diagn ostics, Cartridge Based Nucleic Acid Amplification Test CBNAAT(rapid molecular diagnostic) as a primary diagnostic tool for detection of tuberculosis. Also, TB preventive Therapy is being given to HIV infected individuals.

- (c) & (d): Patients are regularly monitored for routine Viral Load Testing and they are informe whenever their turn is due for routine viral load testing .

## I. The steps taken by the Government for early detection of HIV

## (1) Integrated Counselling and Testing Centre(ICTC)

An Integrated Counseling and Testing Centre (ICTC) presently known as HIV Counselling and testing Service centre (HCTS) is a place where free counseling and testing for HIV is offered to a  person  on  his own free will or as advised by a medical provider. The population availing theservices  is  mainly  Pregnant  and breastfeeding women as well as persons engaged in the high risk behavior,  STI  patients,  TB  patients  and  are  more prone to acquire the HIV infection and the babies born to HIV positive women ( Early Infant Diagnosis)

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In India, ICTCs/HCTS are often the first interface of citizens with the entire gamut of preventive,  care, support and treatment. Currently (till Dec. 2018) HIV counseling and Testing Service is getting to through 29,558 ICTC/HCTS centers.

| Purpose             | Integrated Counselling & Testing Centre (ICTC) is a place where a person is tested for HIV on his own free will or as advised by a medical provider.                                                                                                                                                                                                                                                                                                                                                                                                                   |
|---------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Functions           | Early detection of HIV. Provision of basic information on modes of transmission and prevention of HIV/AIDS promote behavioural change and reduce vulnerability. Link people with other HIV prevention, care and treatment services. ICTC plays a crucial role in early detection of HIV as well as promoting behavioural among the high risk population so as to prevent HIV infection. Prevention of Parent to Child Transmission (PPTCT) Services for HIV infected and Breast feeding mothers. Providing EID (Early Infant Diagnosis) ervices to HIV exposed babies. |
| Priority Population | Populations more vulnerable to HIV or practice high risk behaviour are the & testing at ICTC. It is not the mandate of ICTC to test everybody in the general population.                                                                                                                                                                                                                                                                                                                                                                                               |

## (2) Community Based Screening of HIV (CBS)

National AIDS Control Programme (NACP) has launched Community Based Screening of HIV in 2017. The Community- based screening (CBS) is an important approach for improving early diagnosis,  reaching  first -time testers and people who seldom use clinical services, including men and adolescents in high - prevalence settings and HRG populations. To improve HIV Counselling and Testing Services (HCTS) access and coverage, community- based HIV screening is carried out throughvarious approaches such as

- (i) Mobile HCTS;
- (ii) Screening by ancillary health -care providers (ANC);
- (iii) Screening for HIV by targeted intervention (TI - ICTC);
- (iv) HCTS for prison inmates and
- (v) HCTS at the workplace.

As on Dec 2018, total number of CBS sites established in India is 1821.

## II. Steps taken by Government for Treatment of PLHIV

The Government provides free antiretroviral therapy to all people living with HIV irrespective of th count, age,  gender or population. There are 544 Anti Retroviral Treatment (ART) Centres and 1108 Link ART Centers established all over country.

## III. Steps taken by Government for Viral Load Testing

Viral Load testing  facility is now available, free of cost,  at 525 ART centers.  A private firm contracted for colle ction, transportation, testing and reporting for viral load. Simultaneously expansion of vi testing laboratories in public sector is in process.

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