HIV/AIDS SCENARIO

IN NAGALAND

DR. S.K CHATURVEDI

MD, MNAMS, FIAPSM, FIPHA
 PEOPLE, ECONOMY & INDUSTRY
 83% live in rural area
 40% of rural & 7% urban below poverty

line
 Literacy rate of 67% (M:F=72%:62%)

 Sex ratio less than national average

 Border with Myanmar known entry points

for heroin trafficking

 Secessionist movements a major deterrent

to development
 STATUS OF HIV EPIDEMIC :
reflection from sentinel surveillance
 1990- HIV infection first seen in IDUs (50%)
 1998- Sentinel Surveillance started : 2 sites
 (IDU-14% & STD - 5%)
 2002 – Crosses 1% in ANC
 A shift from concentrated to generalized
epidemic in four years
 Needed ? : NSACS to strengthen its
programme
 Status (contd.)
 Status of AIDS Programme in Nagaland
 
Prevalence rate : 1.28%
 
Prevalence among different populations (2004)

STD clinic attendees : 1.7%

Female Sex workers (Dimapur) : 4.4%
Ante Natal clinic attendees : 1.28%
HIV/TB : 7.2%
Injecting drug users : 2.9%
 WOMEN AND HIV :IN Nagaland
 Diffused sex trade
 High HIV prevalence of 9.7% in FSWs below
20 Yr
 32% o FSWs are migrants
 Needs? Interstate collaborative intervention
-Thorough understanding of
environmental factors and develop
interventions based on it
-Address needs of women not in the
high risk groups
WOMEN AND HIV : contd.

 Knowledge level poor- 37% of rural

had heard of HIV
 Only 53% could ask male to use
condom
 26% only knew all three ways of
transmission
STIGMA & DISCRIMINATION

 Struggle between individual morality

and public health interventions
 More discrimination against women
 Address needs of Children orphaned
by HIV/AIDS
 Need for sensitization of
hospital/health staff
Voluntary Confidential Counselling
and Testing Centre (VCCTC)
 
Presently, the State has 12 VCTCs
established in all the 11 District
Hospitals and Impur Mission Hospital.
The State is beginning to see an
increase in access to VCTC services.
Prevention of Parent to Child
Transmission (PPTCT)
- Total number of centers in the State -13.
- pregnant women going to hospitals for delivery
is low.
- Access to PPTCT services is low.
- Village Health Committees are being trained.
- Importance given to hospital delivery.
Blood Safety
- The State has 8 district level blood banks.
- Voluntary blood donation movement in the State

in process of development.
Information, Education and
Communication (IEC)
- District AIDS Committee (DAC), in all
Districts
- Village Health Committees at village level.
- IEC Action Plan by different Departments.
- Develop effective communication strategies.
Some key infrastructures in place in the
State are:
- State Coordination Committee under the
Chairmanship of the Chief Minister.
- Nagaland Legislative Forum under the Chairmanship
of Minister for Health & FW.
- Committee of Concern under the Chairmanship of
the Chief Secretary.
- State alliance with different partners.
- State IEC Committee including Members from NGOs
and Nagaland Network of Positive People (NNP+).
- District AIDS Committees.
- Coordination committee with NBCC
(Apex Church organization).
- NSACS Web side opened. (www.nagalandaids.com)
School AIDS Education Programme (SAEP)
SAEP has been introduced into the school in the year
2004. A module on AIDS and Drug Prevention
Education has been developed for classes 5 to 8.
Initially, schools in five districts have been covered
in the year 2004-05.
SAEP is now a being owned by education deptt. with
technical support from SACS
 
Police Department
HIV/AIDS training has been incorporated into Police
Training Curriculum.
 
Other Sectors – Government/NGOs/Church etc.
Action Plans being prepared.
Care and Support
 
Community Care Project
- 8 community care projects -1 AIDS
Hospice,
3 Drop- in- centers, 3 Church based care
projects and 1 Network for Positive People.
- Visible Network for PLHAs is important.
- Many members of Network are current drug
users.
Antiretroviral Therapy (ART) Programme
 
Launched on 16th April 2004 at Naga Hospital
Authority, Kohima.
 
Total registered till 31st Dec. 2004 114
Male - 66
Female - 48
Persons put on treatment Deaths
Total- 59 8
Male - 33 4
Female 26 4
ART Programme

- Not accessible to many people from

other Districts.
- All Doctors and Health workers
trained on different aspects of
HIV/AIDs.
- Hesitation to access service from
public sector.
- Need to make services more client
friendly.
 Programme Management
Staffing:
- Need for increased manpower.

Training:
- Much importance given to training.
- Ongoing training needed.
- Hands on Training needed.
- Focus for NGO capacities.
- Develop Training Institutions.

Sentinel Surveillance:
- Urban and Rural included
Intersectoral Collaboration:
- Epidemic driven by Sexual route and IDU
- Need to address contributing factors.
- Comprehensive multisectoral response
needed.
- Strong Political leadership.
- Ownership by all Departments, Church etc.
- Complement and avoid duplication of
activities.
Some Outcomes of the intersectoral
activities
1. The Nagaland Legislative Forum formed.
2. State Coordination Committee under the Chairmanship
of the Chief Minister.
3. All Departments have been directed to identify Nodal
Officer for HIV/AIDS and prepare Action Plans
within each department’s existing infrastructure and
programmes.
4. Committee of Concern under the Chairmanship of the
Chief Secretary.
5. State Alliance of Agencies implementing HIV/AIDS
formed.