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May 2008  
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30 Minute Interview

'Tamil Nadu Has a High Awareness Index on HIV-AIDS'

Tamil Nadu was a state with a prevalence of 1.13 percent of HIV positive and AIDS victims in 2001. Thanks to the various steps taken by the Tamil Nadu State Aids Control Society (TANSACS), the state is now showing a steady decline in the numbers. Supriya Sahu, Project Director, TANSACS speaks to K Deepalakshmi on prevention, treatment and monitoring of HIV in the state. Excerpts:

Supriya Sahu

Project Director, TANSACS Project Director, TANSACS

TANSACS came to existence from 1994. How was HIV-AIDS checked prior to the creation of TANSACS?

The first instance of AIDS in India was reported in Tamil Nadu in the year 1986. The Government of Tamil Nadu started documenting AIDS cases and continued to monitor the status through the ministry of health. Within few years, the AIDS population continued to increase and the State was detected with a high prevalence of (HIV) positive victims (92,312 reported in 1999). The State formed a State AIDS Cell with the funding from World Bank and the National AIDS Control Organisation (NACO). In 1994, this cell was converted into TANSACS.

What is the key difference between TANSACS and other public sector organisations working on HIV?

TANSACS was the first society for AIDS prevention and control in the country. The society model was conceptualised in Tamil Nadu and TANSACS was the first society to work on AIDS control. On seeing the success, the society model was later adopted across India.

TANSACS comprises Integrated Counselling and Testing Centers (ICTC), blood banks, non-governmental organisations, voluntary health service centers and Sexually Transmitted Disease (STD) clinics across the State. The society works on the prevention, treatment and rehabilitation of positive victims.

Can you explain the preventive measures being carried out over the years?

Prevention is achieved through Information Education and Counselling (IEC) campaign. The IEC campaign is designed to create awareness and influence individual behaviour.

Awareness campaigns play a major role in prevention. Initially, awareness campaigns were designed to spread information on HIV and AIDS like 'what is AIDS', 'how it spreads' and 'how it does not' and so on.

This information was disseminated in every possible way. Mass media was used in a large extent in these campaigns. The public was informed about AIDS through television, radio, newspaper and magazines, hoardings and interpersonal communication programmes. The campaign was a roaring success in terms of spreading awareness.

The National Family Health Survey 2006 states that more than 98 per cent of people in Tamil Nadu are aware of HIV.

Even after creating heightened awareness, there is a high prevalence of AIDS here. Why?

Awareness does not result in behaviour change. We know cigarette smoking is injurious to heath, but that doesn't stop people from smoking. We know exercising is good for health, but how many of us exercise regularly?

TANSACS is working on converting the awareness to change in behaviour through consistent programmes and interpersonal skills. We are, in fact, working on multiple fields to cater a vast gamut of audience. We are conducting workshops in companies for their employees on awareness and prevention methods. We are getting tremendous support from various organisations, who have approached us to conduct such workshops in their firms.

What are the current methods employed in creating awareness to target groups?

TANSACS runs major awareness drives among rural women and youth. The rural women are approached by associating with the self help groups. We conduct three-day workshops for women through self-help groups and in association with women development programme.

For college students, we have started red ribbon clubs in about 900 colleges across the State, where the students are educated and encouraged to spread AIDS awareness.

Adolescent education is provided to school students. A massive school education programme is carried out in association with Directorate of School Education. A 14-hour curriculum is developed and covers ninth and eleventh standard students. The curriculum covers hormonal changes, sexual abuse in addition to AIDS awareness. Target intervention programmes are conducted among transgender, commercial sex workers and drug addicts.

What kind of support is extended to positive victims?

TANSACS has established 30 community care centers covering almost all districts across Tamil Nadu. At these centers, the victims are taught how to lead a life after AIDS. The center offers short stay facility, monitors nutrition, checks medications and most importantly looks for any adversities if any.

For positive people, we have lifestyle counseling, we teach them how to live after HIV. They are given counseling on nutrition, the need for being under regular medication and how to lead a sexual life without spreading the infection. We have a good rapport with district collectors. With the help of them, we see to it that these people receive the welfare measures of the Government, like widows' pension.

How do you check the effectiveness of these programmes?

TANSACS has about 750 testing centers. Eight lakh pregnant women were tested through these centers last year and 2,500 were tested positive for HIV. These mothers are given treatment under Pregnant Parent to Children Transmission (PPTCT) treatment. The child can be saved from acquiring the infection— provided the mother undergoes this treatment.

All our centers are connected through our web-based management information system. We check the performance of each center through this system. The IT solution developed by TCS is used to monitor the programmes across the State. The need for medicines, testing kits or any emergencies are communicated through this system.

Please explain the role of NGOS associated with TANSACS.

NGOs play a major role in identifying the positive people and in carrying out the rehabilitation programmes. We classify the victims into two major categories— core group and bridge group. The core group comprise those groups that has high risk and prevalence of infection like commercial sex workers, homosexuals, transgenders and drug addicts. The bridge group are those who transmit the infection from the core group to general population, like migrant labourers and truckers. It is difficult to identify these groups as they are hidden communities. In order to reach these groups, we rope in NGOs, who have already established contacts with these populations.

The NGOs also take part in carrying out rehabilitation programmes for infected persons. They look after the regular follow-up of these people. NGOs also play a major role in carrying out the PPTCT programme.

What is the current status of HIV-AIDS infection in Tamil Nadu?

Tamil Nadu is probably the only State that showed a decline in the infection. But the State has still around 1.78 lakh of infected people. The pool comprises those who were infected in early times. Continuous efforts are made to control the number of fresh infection. The prevalence of infection was 1.13 percent in 2001 and is reduced to 0.34 percent in 2006. The decline is steady and gradual.



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