Kancheepuram DAPCU Response to the Theme: World AIDS Day-2013

In Kancheepuram district, we observed World AIDS Day 2013 on Sunday, 01^st December 2013 at Kancheepuram Collectorate, In guidance of District Collector & District AIDS Control Officer, we organized Cycle Rally from Collectorate to District Sport Stadium with the support of Students community from various in Kancheepuram (approx. 200 students).  This cycle rally covered all over the Kancheepuram Municipality Area with the help of Police officials.  Before starting this rally we took WAD Oath by Students, NGO Officials, Govt. Officials and Public and along with Facility / DAPCU Staff in front of District Collector, Kancheepuram.   Then it had reached District Sport Stadium, during this time State Level Sport meet organized by District Sport Officer, Kancheepuram.  In this sport meet, around 200 sports personalities are participated in all over Tamilnadu. During this time, we circulate Red Ribbon and Pamphlets with the help of volunteers.  It reached to media also.  In continuation that District Collector distributed District Level competition conducted by Principal, DIET, who all are winners / participated of Life Skill Education Programme were received.  

DAPCU Kanyakumari Response to the Theme: Care and Support Services for PLHIVs in the Absence of CCCs

Problems Faced after the closing of CCCs:

For minor OIs we find very difficult to get admissions in Medical College hospital. And patients who are new and need to do basic investigations had have to come long way for two to three days to ARTC. CCC was a good place where only PLHAs can share there problems with out any hesitations as all the patients are PLHAs and the bystanders also know about them.They could talk to everybody in CCC openly.But in hospitals even the staff know about the HIV status the patient in the near by bed is not aware and the PLHA is always in a fear that whether anybody tell them about the HIV satus.Until they are discharged from the hospital they under the fear that the HIV status will be disclosed to others by any of the staff.

Measures have been taken by DAPCU to replace the services given by CCC:

Discussed with DACO and other medical officers about the minor Ois when the PLHAs need admission in the hospital.Now all the MOs of peripheral centres are willing to admit the PLHAs and to give  care to them and also trying to give any other support needed for the PLHAs. Previously when one PLHA come to peripheral centre usually the MO refer them to ARTC. Now the descrimination has come down and most of them are treating the PLHAs in Govt hospitals.

DAPCU Coimbatore Response to : Stigma-Discrimination and DAPCU

Role and responsibilities of DAPCU with respect to stigma and discrimination:
• Main role is positive prevention which benefits and helps to reduce stigma and discrimination.
• Common reasons for stigma and discrimination are described to help counsellors understand the causes behind family and community attitudes and behaviour towards PLHIV. Self- stigma and enacted stigma are both discussed in detail and an assessment tool is provided that enables counsellors to identify the kind of stigma experienced by PLHIV. The DAPCU plays co- ordination of strategies to help clients cope with self and enacted stigma, such as communication skills and exercises to improve self- esteem.

Functions  &  Roles of DAPCU                                    
Coordination :

• Coordinate with PLHIV and reiterate the need for positive prevention.

Monitoring/supervisory :

• Reiterate the counsellors in providing positive prevention counseling to PLHIV.
• Reiterate the need to include prevention at every opportunity in prevention, care and support service delivery. 

    Measures:
• PLHIV can easily access to DAPCU and DPM on all days and their grievance are meeted out.
• In health care settings for surgery and LSCS, Delivery of PLHIV’S attention is immediately given by the DPM by talking to CMO, RMO, DEAN and JDHS.
• Inter department meeting was conducted and same was discussed and their coordination and help was sought by the DAPCU.
• In community setting advocacy work shop was held to minimize stigma and discrimination.
• Complaints was received from the PLHIV and the remedial measures had taken like we got ration card for a PLHIV in ONE DAY which was given by the COLLECTOR, This  PLHIV’s was under stigma by not getting ration card for the past 8 years. 
• THADCO loan, Self- Help group formation was done and the bank people hesitated and discrimination was there for giving loan which were settled by DAPCU and loan were given to PLHIV’s.
• To remove stigma and discrimination, PLHIV’s participated in Grama saba meetings and PRI members assured them to give houses for rental amidst common community.
  

Coimbatore Response to the Theme- Comprehensive HIV/AIDS Services to the HIV Positive Migrants

Intervention package for high risk migrants is outlined below

• Outreach and Communication.
• Peer-led, NGO-supported outreach and behavior change communication (BCC).
• Differentiated outreach based on risk and typology.
• Large-group format activities (e.g. street theatre, games, etc.)
• Interpersonal behavior change communication(IPC)
• Services.
• Promotion of condoms.
• Linkages to STI(sexually transmitted infection) services and other health services (e.g., ICTC, ART, drug/alcohol de-addiction)
• Strong referral and follow-up system.
• Enabling Environment.
• Advocacy With Key  stakeholders/power structures
• Linkages with other programmes and entitlements.
• Community Mobilization.
• Building capacity of migrants group to assume ownership of the programme.
• Prevention is done with the help of migrants programme by one to one and VPL involvements.
• Peer educators involvement.
• The migrants counselor  of various outreach workers distribute pamphlets printed in Telgu, Kannada , Malayalam ,and Tamil with the help of mobile ICTC.
• With the help of self help group follow up and facilities available in district like ICTC linking to ART treatment adherence follow up of MIS and LFU are done with help of M&E, PO & field workers with ART and with DAPCU and it is discussed in monthly review meeting of DAPCU every month.

Experience:

PPTCT services in Coimbatore are done new prophylaxis regimen is started (e. g 1) Name X of Bihar found positive and  then case was referred to ART centre and  CD count done and ART initiated on JULY 19.

 A case Bombay was delivered in CMC  case and ART prophylaxis was  initiated.

 A case Kerala  was delivered in CMC and both the cases PPTCT services were done.

Kanyakumari Response to Theme - Coordination between DAPCUs

Coordination between DAPCUs is very necessary in all the AIDS control activities.

When one patient from some other district is identified in our district we usually contact the concerned DAPCU and share the address of  the patient with them if the patient is not registered in our ART Centre or not coming for regular follow up.Thus we are able to update the details of the patient .

More important thing is if an ANC Positive case is identified the DAPCUs help in following up the clients.We have one ANC positive client who was identified in Nagapattinam District and delivered in Kanyakumari district .We shared the data with Nagapattinam DAPCU .So coordination between DAPCUs not only with in the state but with all DAPCUs in the country is very essential for following up the patient

Also when some other district is doing some good work and sharing the same it can be applied for our DAPCUalso .

Tirpur - Mainstreaming Efforts

By mainstreaming with line departments the message of HIV/AIDS prevention will reach more number of people in the District

Strategies in Tirupur

1. With Mahalir Thittam Department more number of Self Help Groups can be approached and the message of HIV/AIDS prevention will reach more women.
2. With Labour Department more number of Labourers working in the companies and factories can be approached
3. With Education Department more number of College & School students can be approached
4. With Panchayat Raj Department more number of Elected Representatives of Panchayats (Village/Town) can be approached

The Role of DAPCU

1. Whenever monthly meeting of Self Help Groups conducted by the Mahalir Thittam Department DAPCU staff will participate in the meeting and explain HIV/AIDS prevention
2. By having close contact with Labour Department whenever they organise Labour related programmes DAPCU staff will participate in the programme and explain HIV/AIDS prevention

Examples                                 

DAPCU, Tirupur Conducted HIV/AIDS awareness programme at M/s.UNI Source Treend India Company, Perumanallur, Tirupur District on 21.05.2012 for about 250 workers of the above company

On 05.10.2012 Labour Department of Tirupur organized 1-day Conference on “National Policy on HIV/AIDS and the World of work” at Tirupur and DAPCU Tirupur staff by Power point presentation explained the HIV/AIDS prevention

• With Education Department DAPCU RRC District Manager arranges Life Skill Programme for School/College students.  DAPCU staff participated in the programme and explains HIV/AIDS prevention.a. 
• With Panchayat Raj Department whenever they conducted meeting for Elected Representatives DAPCU staff will participate in the meeting and explain HIV/AIDS prevention.
• During Grama Sabha Meetings DAPCU staff and HIV/AIDS service facilities staff will participate in the meeting and explain HIV/AIDS prevention
• During Grama Sabha Meetings held on 15.08.2012 in all 265  Panchayats of Tirupur District HIV/AIDS Oath was taken, District Collector and Govt. Officials are participated in this
• DAPCU staff, HIV/AIDS facilities (ART Centre, ICTC, STI, BB, NGOs) and DPH staff (Medical Officers/Health Inspectors/Village Health Nurse) participated in the Grama Sabha meeting and explained HIV/AIDS prevention

DAPCU Coimbattore, Tamil Nadu Response-September 2012 Theme:

Positive Prevention Programs in Coimbatore District DAPCU

• Voluntary HIV testing and counseling that is confidential, consenting and with appropriate pre and post-test counseling.
• Diagnostic testing to monitor HIV and the immune system and regular screening, diagnosis and treatment of tuberculosis.
• Antiretroviral therapy, including beyond first-line drugs, information and counseling on treatment literacy and services to support adherence to drug regimens.
• Regular screening, diagnosis and treatment of sexually transmitted infections.
• Prevention of opportunistic infections through drug prophylaxis and environmental interventions (nutrition, clean water, bed nets), and treatment when infections occur.
• Ensuring adequate, affordable supplies of male and female condoms and lubricants, and promoting their use.
• Sexual and reproductive health care like contraceptive services, maternal health services, and gynecologic and urologic care.
• Programs to support positive pregnant women and antenatal care to help them promote the health of their unborn child, including preventing parent-to-child transmission.
• Nutritional education, blood safety counseling and assistance.
• Diagnosis, counseling and treatment for depression and other mental health issues, which are common among people living with HIV.
• Counseling to build self-esteem, relationship counseling, risk-reduction counseling, including both individual counseling and skills-building.
• A person living with HIV and Positive Network NGO’s spoken openly and increase solidarity.
• Counseling for sero-discordant couples. These sessions should acknowledge the need for couples to express intimacy through sex and work to identify ways to have sex more safely. Counseling around exercise and encourage regular physical activity.
•  Peer support groups, especially for vulnerable groups including women, young people, young people born positive, sex workers, injecting drug users, and men who have sex with men.
•  Substance use interventions sensitive to the needs of people living with HIV.
•  Help in obtaining a safe, affordable place to live and services to ensure transportation to health clinics and places of employment.
• Child care services to enable parents to obtain health care, to work, and to participate fully in counseling and support activities.
• Employment assistance and income-generating and micro-credit programs
• Legal assistance to cope with issues such as HIV-related discrimination, insurance coverage. Advocacy and counseling trainings to support the greater involvement of people living with HIV.
• Specific training for health care providers in the health care needs of people living with HIV, as well as counseling and training on treating people living with HIV with dignity and respect
• Mass media campaigns to combat stigma and discrimination against people living with HIV.
• Training for journalists in how to report accurately and sensitively on issues related to people living with HIV.

Coimbatore DAPCU is doing above Positive prevention programs in our district. At the same time, positive prevention is linked to other preventive health care efforts, including efforts to prevent HIV transmission. Everyone is responsible for stopping the transmission of HIV and everyone also has a role to play in making sure treatment is available, reducing stigma and discrimination, and reforming punitive and ineffective laws. Positive prevention will succeed “when everyone joins together for the same cause”; successful positive prevention will benefit everyone.

Coimbatore DAPCU's Response to May 2012 Theme - DAPCC Achievements

The advantages of having a DAPCC in the district

• The main objective is Coordination and support with all the departments related with HIV/AIDS programme.

Voter's Id Distribution

Achievements of DAPCU-Coimbatore, which have been the result of the coordination with the departments and stakeholders through the DAPCC. DAPCU in coordination with other departments and by contacting various officials in the district and major support from our District Collector, the following achievements are achieved or benefited by PLHIVs

• Voter ID for 2 FSWs.
• Ration card was sanctioned within one day for 5 PLHIV.
• Loan Rs.1,00,000 each for Self Help Group (SHG)-(2 groups) was sanctioned for positive people in coordination with DAPCU and network NGO.
• THADCO loan Rs.10,000/- each was sanctioned for 15 PLHIV members.(THADCO loan is the loan which need not be refunded)

Ration Card Distribution

Tirupur DAPCU – Response to Question of the Month February 2012 - Facilitating Pre ART Registration

This post was in response to the February 2012 theme

In Tirupur the ICTC Counselor conducts outreach visits and meets positive individuals every Saturday. This is found to be helpful and in GHQH Tirupur , GH Dharapuram and GPHC, Perumanallur  the outreach visits of 3  counselors were able to ensure Pre ART registration of clients within 10 days of their outreach/home visit.

S.No	Name of the ICTC	Name of the Counselor	Client's test date	Counselor Saturday Visit date	Client Pre ART Register date
1	GHQH, Tirupur	Mr.Kannan	30.11.11	10-12-11	15-12-11
2	GH, Dharapuram	Mr.Thangaraj	07.09.11	10.09.2011	14.09.2011
3	GPHC, Perumanallur	Mr.Vijai Prakash	13.01.2012	21.01.2012	28.01.2012

Coimbatore DAPCU – Response to Question of the Month February 2012 - Facilitating ICTC to Pre ART Registration

This post was in response to the February 2012 theme

The following were the strategies  followed by DAPCU, Coimbatore to ensure that people diagnosed HIV positive from ICTCs reach the ART Centre for Pre -ART registration.

1. If positive identified then the details of the positive cases to be mailed to ART centre with a copy to DAPCU.
2. If the identified positive person is pregnant, in addition with the above process, the information is to be communicated to PPTCT NGO. From PPTCT NGO, ORWs are asked to undergo home visit at the earliest for the client registration in ART and further followup.
3. If the patient registered in ART, then the details of ART registration is communicated to all ICTCs on weekly basis with a copy to DAPCU.
4. In Coimbatore district the gap in ART registration has decreased when compared to the situation that was there when the DAPCU had just started functioning.
5. Also maximum all the positives are registered in ART during the month itself.
6. If any positive belongs to other district, the concern ICTC centre is asked to send a mail to other district and ensure the same for ART registration.

The DAPCU monitors these processes on a weekly basis.

Erode DAPCU – Response to Question of the Month February 2012 - Facilitating ICTC to Pre ART Registration

This post was in response to the February 2012 theme

1. PLHIV once identified in ICTC is referred to the ART on the day of identification itself. This follow-up will be done within 7 days to ensure Pre ART registration of the client.
2. If the client does not turn up to the ART center, follow up of the same will be done by the counsellors of the centre in the very next outreach activity.
3. In ANC cases the assistants of the out reach worker of the PPTCT NGO is obtained. In few cases guidance and supportive counselling will be provided by the corresponding ICTC Medical Officer.
4. Rs. 50 supplied by the PACT programme (DIC) is given to the poor ANC positive mothers.
5. HIV positives who are outside of the border of the district Thalavady (This is also the Tamil Nadu, Karnataka, Border) are referred to the Chamrajnagar, Karnataka for their easy accessibility for ART.
6. Other District positive cases are immediately referred to the corresponding district via Phones & Emails to the concerned DAPCU after consent of the PLHIV.