Lok Sabha Question No. 2046 (UNSTARRED), answered on 2015-07-31
Subject: HIV Testing on Pregnant Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DHANANJAY BHIMRAO MAHADIK, SUPRIYA SADANAND SULE, HEENA VIJAYKUMAR GAVIT, RANGASWAMY DHRUVANARAYANA, T. RADHAKRISHNAN, RAJEEV SHANKARRAO SATAV, VIJAYSINH MOHITE PATIL, RODMAL NAGAR, A. ARUNMOZHITHEVAN, RAHUL RAMESH SHEWALE, VINAYAK BHAURAO RAUT, NAGENDRA KUMAR PRADHAN, KALIKESH NARAYAN SINGH DEO, SHRIKANT EKNATH SHINDE

**GOVERNMENT OF INDIA**

**MINISTRY OF HEALTH AND FAMILY WELFARE**

**DEPARTMENT OF HEALTH AND FAMILY WELFARE**

**LOK SABHA**

**UNSTARRED QUESTION NO.2046**

**TO BE ANSWERED ON 31** **ST** **JULY, 2015**

**HIV Testing on Pregnant Women**

**2046. 	SHRI DHANANJAY MAHADIK:**

**SHRIMATI SUPRIYA SULE:**

**DR. HEENA VIJAYKUMAR GAVIT:**

**SHRI R. DHRUVA NARAYANA:**

**SHRI T. RADHAKRISHNAN:**

**SHRI SATAV RAJEEV:**

**SHRI MOHITE PATIL VIJAYSINH SHANKARRAO:**

**SHRI NAGAR RODMAL:**

**SHRI A. ARUNMOZHITHEVAN:**

**SHRI RAHUL SHEWALE:**

**SHRI VINAYAK BHAURAO RAUT:**

**SHRI NAGENDRA KUMAR PRADHAN:**

**SHRI KALIKESH N. SINGH DEO:**

**DR. SHRIKANT EKNATH SHINDE:**

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

(a) the number of pregnant women tested along with the number of them diagnosed with the HIV/AIDS virus during each of the last three years and the current year, State/UT-wise;

(b) the number of cases of Mother-to- Child Transmission (MTCT) of HIV/AIDS virus reported in the country during the said period, State/UT-wise;

(c) whether the Government proposes to train midwives and AYUSH doctors to conduct HIV testing on pregnant women to diagnose the infection at an early stage, if so, the details thereof along with the modalities worked out for the purpose;

(d) whether there is a disparity between the number of HIV/AIDS infected children and those receiving treatment, if so, the details thereof along with the reasons therefor and the corrective steps taken/ proposed by the Government in this regard; and

(e) the other measures taken/proposed by the Government to curb MTCT HIV transmission and to reduce the stigma associated with such mothers and children in the country?

**ANSWER**

**THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND**

**FAMILY WELFARE**

**(SHRI SHRIPAD YESSO NAIK)**

(a):	A statement indicating State/UT wise number of pregnant women tested along with the number of them diagnosed with the HIV/AIDS virus during each of the last three years and the current year is at **Annex-I** .

(b):	A statement indicating State/UT wise number of cases of Mother-to-Child Transmission (MTCT) of HIV/AIDS virus reported in the country during each of the last three years and the current year is at **Annex-II.**

(c):	Under the National AIDS Control Programme (NACP) midwives are already involved in HIV testing of pregnant women who report directly in labour rooms at delivery sites. However, currently, there is no training for AYUSH doctors to conduct HIV testing on pregnant women.

In the year 2011-12, National AIDS Control Organization (NACO) had initiated community based HIV screening using whole blood finger prick testing of pregnant women who come to health facilities for antenatal checkup through Auxiliary Nurse Midwifery (ANM) to identify HIV positive cases, so as to further link with care, support and treatment services provided to People Living with HIV/AIDS (PLHIV). Also unbooked antenatal cases presenting to facilities directly in labour are also tested using the whole blood. NACO provides training to all concerned (i.e. Staff Nurses, Labour Room Nurses and ANMs) in these activities. During 2011-12, more than 4,000 personnel have been trained in this component.

Year-wise details of trained Staff Nurses, Labour Room Nurses and ANMs for HIV screening using whole blood finger prick testing of pregnant women is as below:

|   **S. no.** | **Year**   | **Number of trained Staff Nurses, Labour Room Nurses and ANMs for HIV screening**   |
|--------------|------------|-------------------------------------------------------------------------------------|
|            1 | 2012-13    | 5,142                                                                               |
|            2 | 2013-14    | 11,196                                                                              |
|            3 | 2014-15    | 4,760                                                                               |

(d):	Under National AIDS Control Programme (NACP), children who are eligible for Anti-Retroviral Treatment (ART), as per technical guideline for ART are initiated on ART. As per June’ 2015 a total of 61,173 children have been registered at ART Centers. Out of these, 48,145 are receiving treatment. In order to track children registered at ART centres but are lost to follow up, NACO tries to track them through outreach workers of Care & Support Centers established under NACP.

(e):	Since January, 2014, Government has implemented WHO recommendations on providing lifelong ART to all pregnant and breast-feeding women infected with HIV regardless of CD4 count.

To reduce the stigma and discrimination among PLHIV, multimedia awareness campaigns on Television & Radio, supported by outdoor, mid media like folk performances are conducted through National and State level.

The messages are designed to reach the primary target group i.e. pregnant women, secondary target groups such as spouse and in-laws for implementation of these campaigns on time to time basis.

Similarly, to address the Stigma at different levels like at schools for children and health care settings for pregnant women, the campaigns are designed and implemented by NACO on time to time basis.

In addition, regular trainings and advocacy efforts are also being made by State with education department to address stigma issue related to children and same way with health professionals at different level to address stigma associated with pregnant women.

**Annex – I**

**States /UTs wise number of Pregnant Women tested for HIV and diagnosed HIV positive for the last three years & current year**

| **Sl. no.**                                                                                           | **State/UT s**       | **Year 2012-13**                  |                                          | **Year 2013-14**                  |                                          | **Year 2014-15**                  |                                          | **Year 2015-16***                 |                                          |
|-------------------------------------------------------------------------------------------------------|----------------------|-----------------------------------|------------------------------------------|-----------------------------------|------------------------------------------|-----------------------------------|------------------------------------------|-----------------------------------|------------------------------------------|
|                                                                                                       |                      | **Pregnant women Tested for HIV** | **Pregnant women Detected HIV Positive** | **Pregnant women Tested for HIV** | **Pregnant women Detected HIV Positive** | **Pregnant women Tested for HIV** | **Pregnant women Detected HIV Positive** | **Pregnant women Tested for HIV** | **Pregnant women Detected HIV Positive** |
| 1                                                                                                     | Andaman & Nicobar    | 6,430                             | 0                                        | 4,955                             | 4                                        | 5,557                             | 0                                        | 999                               | 0                                        |
| 2                                                                                                     | Andhra Pradesh**     | 1,141,437                         | 2,810                                    | 1,093,870                         | 2,388                                    | 1231209                           | 2107                                     | 360,740                           | 427                                      |
| 3                                                                                                     | Arunachal Pradesh    | 9,482                             | 3                                        | 6,990                             | 1                                        | 9,851                             | 6                                        | 305                               | 0                                        |
| 4                                                                                                     | Assam                | 234,370                           | 117                                      | 196,538                           | 101                                      | 211,763                           | 96                                       | 52,589                            | 14                                       |
| 5                                                                                                     | Bihar                | 187,450                           | 248                                      | 301,524                           | 416                                      | 466,157                           | 427                                      | 19,271                            | 107                                      |
| 6                                                                                                     | Chandigarh           | 22,561                            | 42                                       | 22,517                            | 36                                       | 24,986                            | 37                                       | 8,039                             | 0                                        |
| 7                                                                                                     | Chhattisgarh         | 77,479                            | 159                                      | 111,257                           | 169                                      | 141,495                           | 214                                      | 40,715                            | 44                                       |
| 8                                                                                                     | Dadra & Nagar Haveli | 6,088                             | 5                                        | 7,242                             | 11                                       | 8,827                             | 8                                        | 2,765                             | 0                                        |
| 9                                                                                                     | Daman & Diu          | 3,418                             | 5                                        | 2,037                             | 8                                        | 3,656                             | 6                                        | 595                               | 0                                        |
| 10                                                                                                    | Delhi                | 206,388                           | 338                                      | 196,113                           | 332                                      | 237,675                           | 326                                      | 35,425                            | 72                                       |
| 11                                                                                                    | Goa                  | 15,953                            | 26                                       | 13,138                            | 26                                       | 15,947                            | 18                                       | 2,744                             | 0                                        |
| 12                                                                                                    | Gujarat              | 656,026                           | 701                                      | 774,747                           | 813                                      | 846,015                           | 610                                      | 207,709                           | 132                                      |
| 13                                                                                                    | Haryana              | 189,580                           | 244                                      | 216,180                           | 265                                      | 215,036                           | 173                                      | 5,441                             | 33                                       |
| 14                                                                                                    | Himachal Pradesh     | 55,347                            | 32                                       | 46,570                            | 27                                       | 51,908                            | 17                                       | 7,175                             | 0                                        |
| 15                                                                                                    | Jammu & Kashmir      | 53,890                            | 24                                       | 10,123                            | 15                                       | 35,733                            | 11                                       | 10,230                            | 0                                        |
| 16                                                                                                    | Jharkhand            | 92,059                            | 76                                       | 96,039                            | 82                                       | 163,858                           | 79                                       | 19,202                            | 10                                       |
| 17                                                                                                    | Karnataka            | 1,044,706                         | 2,232                                    | 1,172,894                         | 1,445                                    | 1,232,456                         | 1,295                                    | 285,970                           | 224                                      |
| 18                                                                                                    | Kerala  #            | 137,565                           | 63                                       | 161,753                           | 44                                       | 153510                            | 51                                       | 24,471                            | 5                                        |
| 19                                                                                                    | Madhya Pradesh       | 491,043                           | 319                                      | 510,463                           | 336                                      | 611,980                           | 396                                      | 128,257                           | 79                                       |
| 20                                                                                                    | Maharashtra          | 1,257,646                         | 1,931                                    | 1,576,921                         | 1,814                                    | 2,065,315                         | 1,653                                    | 499,325                           | 313                                      |
| 21                                                                                                    | Manipur              | 48,713                            | 151                                      | 40,028                            | 124                                      | 52,845                            | 115                                      | 6,877                             | 19                                       |
| 22                                                                                                    | Meghalaya            | 17,257                            | 57                                       | 21,577                            | 71                                       | 20,989                            | 149                                      | 5,499                             | 27                                       |
| 23                                                                                                    | Mizoram              | 20,271                            | 124                                      | 18,880                            | 132                                      | 26,858                            | 126                                      | 3,541                             | 22                                       |
| 24                                                                                                    | Nagaland             | 19,608                            | 151                                      | 19,588                            | 163                                      | 18,571                            | 211                                      | 5,290                             | 43                                       |
| 25                                                                                                    | Orissa               | 274,995                           | 272                                      | 289,899                           | 233                                      | 285,234                           | 254                                      | 77,520                            | 54                                       |
| 26                                                                                                    | Pondicherry          | 31,640                            | 16                                       | 32,286                            | 10                                       | 29,804                            | 12                                       | 7,717                             | 0                                        |
| 27                                                                                                    | Punjab               | 227,911                           | 275                                      | 162,784                           | 260                                      | 289,750                           | 210                                      | 8,696                             | 43                                       |
| 28                                                                                                    | Rajasthan            | 386,007                           | 381                                      | 474,179                           | 412                                      | 576,558                           | 469                                      | 128,903                           | 107                                      |
| 29                                                                                                    | Sikkim               | 8,495                             | 6                                        | 9,893                             | 3                                        | 10,382                            | 2                                        | 1,936                             | 0                                        |
| 30                                                                                                    | Tamil Nadu           | 842,014                           | 749                                      | 976,969                           | 1,256                                    | 992,132                           | 593                                      | 229,016                           | 138                                      |
| 31                                                                                                    | Tripura              | 23,701                            | 20                                       | 23,957                            | 32                                       | 29,944                            | 25                                       | 6,327                             | 0                                        |
| 32                                                                                                    | Uttar Pradesh        | 493,925                           | 445                                      | 504,878                           | 481                                      | 652,447                           | 619                                      | 180,835                           | 145                                      |
| 33                                                                                                    | Uttaranchal          | 68,823                            | 51                                       | 73,590                            | 49                                       | 92,872                            | 51                                       | 5,138                             | 6                                        |
| 34                                                                                                    | West Bengal          | 479,576                           | 478                                      | 581,745                           | 449                                      | 880,359                           | 475                                      | 112,660                           | 109                                      |
| **Total**                                                                                             |                      | **8,831,854**                     | **12,551**                               | **9,752,124**                     | **12,008**                               | **11,691,679**                    | **10,841**                               | **2,491,922**                     | **2,173**                                |
| *  **till June 2015**  ** Andhra Pradesh also Includes Telengana,  # Kerala also includes Lakshadweep |                      |                                   |                                          |                                   |                                          |                                   |                                          |                                   |                                          |

**Annex-II**

**States /UTs wise HIV positive case diagnosed through Parent to Child transmission for the last three years and current year**

| **Sl. no.**   | **State/UTs**             | **2012-13**   | **2013-14**   | **2014-15**   | **2015-16***   |
|---------------|---------------------------|---------------|---------------|---------------|----------------|
| 1             | Andaman & Nicobar Islands | 0             | 0             | 0             | 0              |
| 2             | Andhra Pradesh*           | 123           | 69            | 18            | 10             |
| 3             | Arunachal Pradesh         | 0             | 0             | 0             | 0              |
| 4             | Assam                     | 5             | 0             | 0             | 1              |
| 5             | Bihar                     | 8             | 5             | 6             | 2              |
| 6             | Chandigarh                | 4             | 6             | 2             | 0              |
| 7             | Chhattisgarh              | 10            | 8             | 0             | 2              |
| 8             | Dadra & Nagar Haveli      | 0             | 0             | 0             | 0              |
| 9             | Daman & Diu               | 0             | 0             | 0             | 0              |
| 10            | Delhi                     | 16            | 20            | 10            | 9              |
| 11            | Goa                       | 4             | 2             | 0             | 0              |
| 12            | Gujarat                   | 88            | 92            | 28            | 12             |
| 13            | Haryana                   | 1             | 2             | 0             | 0              |
| 14            | Himachal Pradesh          | 0             | 0             | 0             | 0              |
| 15            | Jammu & Kashmir           | 0             | 0             | 0             | 0              |
| 16            | Jharkhand                 | 3             | 3             | 2             | 1              |
| 17            | Karnataka                 | 110           | 72            | 32            | 5              |
| 18            | Kerala                    | 3             | 3             | 1             | 2              |
| 19            | Lakshadweep               | 0             | 0             | 0             | 0              |
| 20            | Madhya Pradesh            | 23            | 15            | 3             | 3              |
| 21            | Maharashtra               | 179           | 268           | 200           | 18             |
| 22            | Manipur                   | 2             | 6             | 0             | 0              |
| 23            | Meghalaya                 | 0             | 4             | 0             | 0              |
| 24            | Mizoram                   | 3             | 4             | 0             | 1              |
| 25            | Nagaland                  | 0             | 3             | 4             | 0              |
| 26            | Odisha                    | 3             | 8             | 3             | 0              |
| 27            | Puducherry                | 1             | 0             | 1             | 0              |
| 28            | Punjab                    | 4             | 8             | 5             | 0              |
| 29            | Rajasthan                 | 6             | 11            | 21            | 1              |
| 30            | Sikkim                    | 0             | 0             | 0             | 0              |
| 31            | Tamil Nadu                | 39            | 25            | 20            | 4              |
| 32            | Tripura                   | 0             | 0             | 0             | 0              |
| 33            | Uttar Pradesh             | 33            | 39            | 10            | 0              |
| 34            | Uttaranchal               | 1             | 1             | 0             | 0              |
| 35            | West Bengal               | 34            | 19            | 14            | 2              |
| **TOTAL**     |                           | **703**       | **693**       | **380**       | **73**         |

* **till May 2015**

* Andhra Pradesh also Includes Telengana,